Department of Rheumatology, Lille Catholic Hospitals, University of Lille, F-59160, Lomme, France; EA 4490, PMOI, Physiopathologie des Maladies Osseuses Inflammatoires, University of Lille, F-59000, Lille, France.
EA 4490, PMOI, Physiopathologie des Maladies Osseuses Inflammatoires, University of Lille, F-59000, Lille, France; Department of Rheumatology, Hopital Salengro, Centre Hospitalier Universitaire de Lille, University of Lille, F-59000, Lille, France.
Bone. 2020 Jan;130:115099. doi: 10.1016/j.bone.2019.115099. Epub 2019 Oct 22.
The potency of magnetic resonance imaging (MRI) to measure the exact extent of osteonecrosis of the femoral head (ONFH) remains uncertain. The objective of this study was to determine if the volume of necrosis assessed with MRI accurately reflects the volume of architectural mineral alterations in osteonecrosis of the femoral head by comparison with high-resolution microfocus X-ray computed tomography (HR-μCT). Fourteen male patients aged 53 years [46.2;59.0] suffering from ONFH were prospectively enrolled to undergo preoperative MRI and ex vivo analysis using HR-μCT. The necrotic zone on T1-weighted MRI scans was defined as total necrosis (delimited by the low-signal peripheral band) or dark necrosis (low-signal lesions only). The HR-μCT scans delimited outer necrosis and inner necrosis by including or excluding the sclerotic zone. The intra-class correlation coefficient (ICC) was calculated to compare the agreement of surface areas and volumes of necrosis measurements with the two techniques. There was an overall excellent agreement between MRI dark necrosis volume and HR-μCT outer necrosis volume (ICC=0.91[0.54;0.98]) while the MRI total necrosis volume showed poor agreement with both HR-μCT delimitations of necrosis volume. For surface area, agreement between MRI dark necrosis and HR-μCT delimitations was good for inner necrosis (ICC=0.70[0.21;0.9]) and moderate for outer necrosis (ICC=0.58[0.07;0.85]). This study demonstrates that measurement of the MRI lesions provides a reliable assessment of the extent of ONFH-related architectural damage.
磁共振成像（MRI）测量股骨头坏死（ONFH）的确切范围的效力仍不确定。本研究的目的是通过与高分辨率微焦点 X 射线计算机断层扫描（HR-μCT）比较，确定 MRI 评估的坏死体积是否准确反映股骨头坏死的结构矿物质改变的体积。14 名年龄为 53 岁[46.2；59.0]的男性 ONFH 患者前瞻性纳入本研究，进行术前 MRI 和 HR-μCT 体外分析。T1 加权 MRI 扫描上的坏死区定义为全坏死（由低信号外周带划定）或暗坏死（仅低信号病变）。HR-μCT 扫描通过包含或排除硬化区来划定外坏死和内坏死。通过计算组内相关系数（ICC）来比较两种技术测量的坏死面积和体积的一致性。MRI 暗坏死体积与 HR-μCT 外坏死体积之间存在总体上极好的一致性（ICC=0.91[0.54；0.98]），而 MRI 全坏死体积与 HR-μCT 两种坏死体积界定均显示出较差的一致性。对于面积，MRI 暗坏死与 HR-μCT 内坏死界定之间的一致性良好（ICC=0.70[0.21；0.9]），外坏死的一致性为中等（ICC=0.58[0.07；0.85]）。本研究表明，MRI 病变的测量可可靠评估与 ONFH 相关的结构损伤的程度。
