CT and MRI findings beyond the subchondral bone in osteonecrosis of the femoral head to distinguish between ARCO stages 2 and 3A

Kim, Jiyoung; Lee, Seul Ki; Kim, Jee Young; Kim, Junho

doi:10.1007/s00330-023-09403-8

Cited by 4 publications

(2 citation statements)

References 37 publications

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“…Previous studies from Xu et al have con rmed that ESWT can alleviate hip joint pain and promote recovery of hip joint function 20 . Some patients showed necrotic area reduction on MRI images in ESWTtargeted early femoral head necrosis treatment 21 . Wang et al and Vulpiani et al showed a similar conclusion in the long-term follow-up and metrological effects of ESWT when it was used to treat ONFH 10,22 .…”

Section: Discussionmentioning

confidence: 98%

Investigate an optimal extracorporeal shock wave therapy intervention strategy for osteonecrosis of femoral head : a retrospective analysis

Zhu,

Xiao,

et al. 2024

Preprint

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Purpose: To investigate an optimal ESWT intervention strategy in the management of ONFH. Methods: An analysis of medical records was performed retrospectively on 75 patients who received extracorporeal shock wave therapy(ESWT) between June 2021 and July 2023, all patients affected by ONFH. These patients underwent MRI before treatment, 3 months, and 1 year after treatment to measure their volume; their Harris and VAS were recorded at the corresponding time points. Correlation analysis and regression analysis were performed to examine the correlation between necrotic volume and Harris, VAS before treatment and the correlation between the change of necrotic volume size and the evolution of HHS 1 year after treatment. Results:A statistically significant correlation between the size of the necrotic volume and the Harris and VAS was demonstrated before treatment(P＜0.001). Three months after treatment, there were significant improvements in Harris and VAS(P＜0.001) but unchanged in MRI images. One year after treatment, the Harris, VAS, and size of necrotic volume from 13 patients were significantly improved(P＜0.001), and Linear regression analysis indicated a significant positive correlation between the size of the necrotic volume and clinical improvement(P＜0.001). Conclusion: The volume of osteonecrosis of the femoral head was negatively correlated with Harris and positively correlated with VAS. The reduction of necrotic volume was related to clinical improvement. It shows that the degree of pain is one of the critical references to reflect the size of necrosis and physiotherapists can choose interval between two cycles according to their own changes in pain conditions.

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Section: Discussionmentioning

confidence: 98%

Investigate an optimal extracorporeal shock wave therapy intervention strategy for osteonecrosis of femoral head : a retrospective analysis

Zhu,

Xiao,

et al. 2024

Preprint

View full text Add to dashboard Cite

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“…When the proportion is > 30%, the collapse risk is low, whereas at < 30%, the risk is high. Second, cystic lesions, often close to RI in viable areas of the femoral head, could be a common pathologic feature in ONFH but not in SFFFH[ 31 ]. Gao et al [ 32 ] also observed that the predilection locations of cystic lesions were mainly close to RI in ONFH and the main factor inducing the formation of cystic lesions may be the peak stress at RI edge via an osteoarthritis-like mechanism.…”

Section: Discussionmentioning

confidence: 99%

Subchondral fatigue fracture of the femoral head in young military recruits: Potential risk factors

Yang,

Chen,

Chen

et al. 2023

World J Clin Cases

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β cells are the main cells responsible for the hypoglycemic function of pancreatic islets, and the insulin secreted by these cells is the only hormone that lowers blood glucose levels in the human body. β cells are regulated by various factors, among which neurotransmitters make an important contribution. This paper discusses the effects of neurotransmitters secreted by various sympathetic and parasympathetic nerves on β cells and summarizes the mechanisms by which various neurotransmitters regulate insulin secretion. Many neurotransmitters do not have a single source and are not only released from nerve terminals but also synthesized by β cells themselves, allowing them to synergistically regulate insulin secretion. Almost all of these neurotransmitters depend on the presence of glucose to function, and their actions are mostly related to the Ca2+ and cAMP concentrations. Although neurotransmitters have been extensively studied, many of their mechanisms remain unclear and require further exploration by researchers.

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Deep learning enables the differentiation between early and late stages of hip avascular necrosis

et al. 2023

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Objectives To develop a deep learning methodology that distinguishes early from late stages of avascular necrosis of the hip (AVN) to determine treatment decisions. Methods Three convolutional neural networks (CNNs) VGG-16, Inception ResnetV2, InceptionV3 were trained with transfer learning (ImageNet) and finetuned with a retrospectively collected cohort of (n = 104) MRI examinations of AVN patients, to differentiate between early (ARCO 1–2) and late (ARCO 3–4) stages. A consensus CNN ensemble decision was recorded as the agreement of at least two CNNs. CNN and ensemble performance was benchmarked on an independent cohort of 49 patients from another country and was compared to the performance of two MSK radiologists. CNN performance was expressed with areas under the curve (AUC), the respective 95% confidence intervals (CIs) and precision, and recall and f1-scores. AUCs were compared with DeLong’s test. Results On internal testing, Inception-ResnetV2 achieved the highest individual performance with an AUC of 99.7% (95%CI 99–100%), followed by InceptionV3 and VGG-16 with AUCs of 99.3% (95%CI 98.4–100%) and 97.3% (95%CI 95.5–99.2%) respectively. The CNN ensemble the same AUCs Inception ResnetV2. On external validation, model performance dropped with VGG-16 achieving the highest individual AUC of 78.9% (95%CI 51.6–79.6%) The best external performance was achieved by the model ensemble with an AUC of 85.5% (95%CI 72.2–93.9%). No significant difference was found between the CNN ensemble and expert MSK radiologists (p = 0.22 and 0.092 respectively). Conclusion An externally validated CNN ensemble accurately distinguishes between the early and late stages of AVN and has comparable performance to expert MSK radiologists. Clinical relevance statement This paper introduces the use of deep learning for the differentiation between early and late avascular necrosis of the hip, assisting in a complex clinical decision that can determine the choice between conservative and surgical treatment. Key Points • A convolutional neural network ensemble achieved excellent performance in distinguishing between early and late avascular necrosis. • The performance of the deep learning method was similar to the performance of expert readers.

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CT and MRI findings beyond the subchondral bone in osteonecrosis of the femoral head to distinguish between ARCO stages 2 and 3A

Cited by 4 publications

References 37 publications

Investigate an optimal extracorporeal shock wave therapy intervention strategy for osteonecrosis of femoral head : a retrospective analysis

Investigate an optimal extracorporeal shock wave therapy intervention strategy for osteonecrosis of femoral head : a retrospective analysis

Subchondral fatigue fracture of the femoral head in young military recruits: Potential risk factors

Deep learning enables the differentiation between early and late stages of hip avascular necrosis

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