Inaoka Tsutomu, Sugeta Masayuki, Nakatsuka Tomoya, Kasuya Shusuke, Ishikawa Rumiko, Sugiura Yoshiya, Nakajima Arata, Nakagawa Koichi, Yamamoto Akinori, Terada Hitoshi
Department of Radiology, Toho University Sakura Medical Center, Sakura, Chiba, Japan.
Department of Diagnostic Pathology, Toho University Sakura Medical Center, Sakura, Chiba, Japan.
Magn Reson Med Sci. 2025 Jan 1;24(1):20-34. doi: 10.2463/mrms.mp.2023-0028. Epub 2024 Jan 16.
To evaluate the significant findings of hip periprosthetic joint infection (PJI) using metal-artifact-reduction (MAR) MRI and to compare the MRI results to other clinical markers.
The results of MRI, including two-dimensional fast-spin echo sequences with increased bandwidth and multi-acquisition variable-resonance image combination selective for hips with orthopedic implants at 1.5T (from April 2014 to November 2021), were retrospectively assessed for imaging findings and diagnostic impressions by two radiologists. Clinical data and courses were also investigated. Univariate and multivariate analyses were performed to identify the significant MRI findings in patients with hip PJI and those who underwent surgical intervention. The MRI impressions were compared with other clinical markers in diagnosing hip PJI.
Thirty-seven hip joints in 24 Asian patients (age = 73.9 ± 10.8 years; 18 females) were included. Twelve hip joints (32%) had PJI; seven underwent a surgical intervention. The significant findings for hip PJI included periosteal edema of the acetabulum, intermuscular edema, intramuscular fluid collection, and lymphadenopathy (P < 0.05). In the cases with surgical intervention, the significant findings included capsular distension, capsular thickening, an osteolysis-like pattern of the femur, subcutaneous fluid collection, and lymphadenopathy (P < 0.05). The MRI impressions had high diagnostic significance for both hip PJI cases and those with surgical intervention (P < 0.001). The MRI impression was more significant for hip PJI than the other clinical markers (P < 0.05), while the other clinical markers were more significant in the cases with surgical intervention (P < 0.05).
The significant findings in the hip PJI cases included acetabular periosteal edema, intermuscular edema, intramuscular fluid collection, and lymphadenopathy. The significant findings in the cases with surgical intervention included capsular distention, capsular thickening, a femoral osteolysis-like pattern, subcutaneous fluid collection, and lymphadenopathy. The utilization of MAR MRI demonstrated great diagnostic significance for hip PJI.
利用金属伪影减少（MAR）磁共振成像（MRI）评估髋关节假体周围感染（PJI）的重要发现，并将MRI结果与其他临床指标进行比较。
回顾性评估2014年4月至2021年11月期间在1.5T下对有骨科植入物的髋关节进行的MRI结果，包括具有增加带宽的二维快速自旋回波序列和多采集可变共振图像组合，由两名放射科医生评估成像结果和诊断印象。还调查了临床数据和病程。进行单因素和多因素分析，以确定髋关节PJI患者和接受手术干预患者的重要MRI发现。将MRI印象与诊断髋关节PJI的其他临床指标进行比较。
纳入24例亚洲患者（年龄=73.9±10.8岁；18名女性）的37个髋关节。12个髋关节（32%）发生PJI；7个接受了手术干预。髋关节PJI的重要发现包括髋臼骨膜水肿、肌间水肿、肌内积液和淋巴结病（P<0.05）。在接受手术干预的病例中，重要发现包括关节囊扩张、关节囊增厚、股骨类似骨溶解的模式、皮下积液和淋巴结病（P<0.05）。MRI印象对髋关节PJI病例和接受手术干预的病例均具有较高的诊断意义（P<0.001）。MRI印象对髋关节PJI的诊断意义大于其他临床指标（P<0.05），而其他临床指标在接受手术干预的病例中更具诊断意义（P<0.05）。
髋关节PJI病例的重要发现包括髋臼骨膜水肿、肌间水肿、肌内积液和淋巴结病。接受手术干预病例的重要发现包括关节囊扩张、关节囊增厚、股骨类似骨溶解的模式、皮下积液和淋巴结病。MAR MRI的应用对髋关节PJI具有重要的诊断意义。
