Evaluation of Labral Pathology and Hip Articular Cartilage in Patients with Femoroacetabular Impingement (FAI): Comparison of Multidetector CT Arthrography and MR Arthrography

Abstract

SummaryBackgroundTo compare the multidetector computed tomography (MDCT) arthrography (CTa) and magnetic resonance (MR) arthrography (MRa) findings with surgical findings in patients with femoroacetabular impingement (FAI) and to evaluate the diagnostic performance of these methods.Material/MethodsLabral pathology and articular cartilage were prospectively evaluated with MRa and CTa in 14 hips of 14 patients. The findings were evaluated by two musculoskeletal radiologists with 10 and 20 years of experience, respectively. Sensitivity, specificity, accuracy, and positive predictive value were determined using surgical findings as the standard of reference.ResultsWhile the disagreement between observers was recorded in two cases of labral tearing with MRa, there was a complete consensus with CTa. Disagreement between observers was found in four cases of femoral cartilage loss with both MRa and CTa. Disagreement was also recorded in only one case of acetabular cartilage loss with both methods. The percent sensitivity, specificity, and accuracy for correctly assessing the labral tearing were as follows for MRa/CTa, respectively: 100/100, 50/100, 86/100 (p<0.05). The same values for acetabular cartilage assessment were 89/56, 40/60, 71/71 (p>0.05) and for femoral cartilage assessment were 100/75, 90/70, 86/71 (p>0.05). Inter-observer reliability value showed excellent agreement for labral tearing with CTa (κ=1.0). Inter-observer agreement was substantial to excellent with regard to acetabular cartilage assessment with MRa and CTa (κ=0.76 for MRa and κ=0.86 for CTa)ConclusionsInter-observer reliability with CTa is excellent for labral tearing assessment. CTa seems to have an equal sensitivity and a higher specificity than MRa for the detection of labral pathology. MRa is better, but not statistically significantly, in demonstrating acetabular and femoral cartilage pathology.

Radiographic Diagnosis of Pincer-Type Femoroacetabular Impingement: A Systematic Review

“…Sutter et al 47 compared the accuracy of MRA and conventional MRI using the intraoperative findings of labral tear and acetabular cartilage damage as a reference and concluded that MRA is more accurate. A study by Sahin et al 42 compared the accuracy of CT arthrography and MRA based on intraoperative findings and showed that both are accurate in detecting labral tears and cartilage pathologies. Despite the potential utility of CT arthrography, plain radiographs and MRI are the traditionally accepted imaging methods, with more studies supporting the use of these imaging modalities compared with CT arthrography.…”

Accuracy of magnetic resonance studies in the detection of chondral and labral lesions in femoroacetabular impingement: systematic review and meta-analysis

“…Four studies [ 12 , 13 , 33 , 38 ] assessed the accuracy of dMRA in detection of acetabular chondral lesions, the pooled sensitivity and specificity for these studies were 0.86 and 0.68 respectively, and AUC was 0.86. Four studies [ 12 , 13 , 33 , 38 ] assessed the accuracy of dMRA in detection of femoral head chondral lesions, the pooled sensitivity and specificity for these studies were 0.69 and 0.75 respectively, and AUC was 0.75. Two studies [ 36 , 37 ] assessed the accuracy of dMRA in detection of combined chondral lesions, the pooled sensitivity and specificity for these studies were 0.51 and 0.88 respectively.…”

Diagnostic value of magnetic resonance imaging and magnetic resonance arthrography for assessing acetabular labral tears: A systematic review and meta-analysis

“…After screening layer by layer, 29 articles were finally included. [20–48] The process and the results of literature screening are shown in Figure 1.…”