Dynamic contrast-enhanced magnetic resonance imaging can assess vascularity within fracture non-unions and predicts good outcome

Schoierer, Oliver; Bloess, Konstantin; Bender, Daniel; Burkholder, Iris; Kauczor, Hans‐Ulrich; Schmidmaier, Gerhard; Weber, Marc‐André

doi:10.1007/s00330-013-3043-3

Cited by 30 publications

(21 citation statements)

References 47 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…A senior musculoskeletal radiologist, who was blinded to any clinical information, evaluated the signal intensity curves of the dynamic contrast‐enhanced MRI scans, and nonunions were categorized qualitatively as hypervascular if the nonunion gap showed stronger contrast enhancement than the surrounding muscle tissue (>20% higher relative enhancement) 9 …”

Section: Methodsmentioning

confidence: 99%

See 1 more Smart Citation

Dynamic Contrast‐Enhanced Sonography and Dynamic Contrast‐Enhanced Magnetic Resonance Imaging for Preoperative Diagnosis of Infected Nonunions

Fischer

Preuss

Tanner

et al. 2016

J of Ultrasound Medicine

Self Cite

View full text Add to dashboard Cite

show abstract

Section: Methodsmentioning

confidence: 99%

“…The vascularity of nonunions can be assessed with dynamic contrast‐enhanced magnetic resonance imaging (MRI), 9 which is routinely used as a preoperative imaging method at our institution. Dynamic contrast‐enhanced MRI has not been validated yet for differentiation between infected and aseptic nonunions.…”

mentioning

confidence: 99%

Dynamic Contrast‐Enhanced Sonography and Dynamic Contrast‐Enhanced Magnetic Resonance Imaging for Preoperative Diagnosis of Infected Nonunions

Fischer

Preuss

Tanner

et al. 2016

J of Ultrasound Medicine

Self Cite

View full text Add to dashboard Cite

show abstract

“…It has the optimal consistency and can establish good primary stability as a tricortical graft. Problematic is the limited availability and differing quality and quantity as well as a high extraction morbidity (25,(42)(43)(44)(45)(46).…”

Section: Isolation Of Bone Replacement Materialsmentioning

confidence: 99%

“…This method is primarily performed on the femur, but can also be done on the tibia. In this way, it is possible to extract 80 cm of the autologous bone material for transplantation (25,35,(43)(44)(45)(46)(47)(48) (an alternative to extraction of cancellous bone from the iliac crest is the RIA method, which involves winning cancellous bone out of the femur).…”

Section: Isolation Of Bone Replacement Materialsmentioning

confidence: 99%

See 1 more Smart Citation

Non-Union Current Treatment Concept

2016

Self Cite

View full text Add to dashboard Cite

Context: This article wants to give a current concept for the challenging decision for conservative or operative treatment strategies of nonunions according to the principles of 'diamond concept' and aspects that have to be attended. Evidence Acquisition: Between February 2010 and March 2014, 424 patients with non-unions were treated at Heidelberg university hospital. This database has been analyzed at least one year after the treatment. The analysis and the experience in surgery and treatment of non-unions as well as present literature were prepared for this review as a current concept. Results: If an atrophic non-union is suggested, reosteosynthesis and biological stimulation is required. A revision surgery of autologous transplantation of cancellous bone from the iliac crest is often enough. Alternatively, reamer-irrigator-aspirator (RIA) can be taken out of the femur with lower complications and pain in the extraction area and be combined with growth factors like bone morphogenetic proteins (BMPs), if consolidation after cancellous bone is still absent. In complex cases, consequential and radical removal of the infection often improved circulation through interventional angiography and use of the two-step procedure (the Masquelet technique) as well as a tissue covering are required. Conclusions: By using the 'diamond concept' as a complex concept, non-unions can be treated in different stages in a targeted manner.

show abstract

Posttraumatic Perfusion Analysis of Quadriceps, Patellar, and Achilles Tendon Regeneration With Dynamic Contrast‐Enhanced Ultrasound and Dynamic Contrast‐Enhanced Magnetic Resonance Imaging

Fischer

Miska

Jung

et al. 2020

J of Ultrasound Medicine

Self Cite

View full text Add to dashboard Cite

Objectives The healing process of tendons after surgical treatment of tendon ruptures mainly depends on the perfusion of the tendon and its surrounding tissue. Dynamic contrast‐enhanced ultrasound (DCE‐US) and dynamic contrast‐enhanced MRI (DCE‐MRI) can provide additional information about the local microperfusion. In this pilot study, the feasibility of these techniques to assess the vascularization during tendon regeneration was evaluated. Methods Between 2013 and 2015, 23 patients with surgical treatment of traumatic rupture of quadriceps, patellar, and Achilles tendons were involved. All patients received clinical follow‐up examinations at 6, 12, and at least 52 weeks postoperatively. Dynamic contrast‐enhanced US and DCE‐MRI examinations were performed 6 and 12 weeks postoperatively. Dynamic contrast‐enhanced US perfusion was quantified by the parameters peak enhancement, wash‐in area under the curve, rise time, and initial area under the curve. Correlations between these parameters were examined via the Spearman rank correlation. The clinical and functional outcomes were assessed via the Lysholm Knee Score and Knee and Osteoarthritis Outcome Score at 12 and 52 weeks postoperatively. Results Fourteen patients with quadriceps (n = 8), patellar (n = 4) and Achilles (n = 2) tendon ruptures with complete follow‐up were available. The microperfusion could be successful assessed. We could detect a strong correlation of DCE‐US (peak enhancement) parameters with DCE‐MRI (initial area under the curve) parameters after 6 and 12 weeks. Conclusions In this pilot study, DCE‐US was able to visualize the microperfusion of healing tendons with a strong correlation with DCE‐MRI. Our initial results are in favor of DCE‐US as a potential quantitative imaging tool for evaluating the vascularization in tendon regeneration as a complementary method.

show abstract

Dynamic contrast-enhanced magnetic resonance imaging can assess vascularity within fracture non-unions and predicts good outcome

Cited by 30 publications

References 47 publications

Dynamic Contrast‐Enhanced Sonography and Dynamic Contrast‐Enhanced Magnetic Resonance Imaging for Preoperative Diagnosis of Infected Nonunions

Dynamic Contrast‐Enhanced Sonography and Dynamic Contrast‐Enhanced Magnetic Resonance Imaging for Preoperative Diagnosis of Infected Nonunions

Non-Union Current Treatment Concept

Posttraumatic Perfusion Analysis of Quadriceps, Patellar, and Achilles Tendon Regeneration With Dynamic Contrast‐Enhanced Ultrasound and Dynamic Contrast‐Enhanced Magnetic Resonance Imaging

Contact Info

Product

Resources

About