MR Perfusion Index as a Quantitative Method of Evaluating Epiphyseal Perfusion in Legg-Calve-Perthes Disease and Correlation With Short-term Radiographic Outcome

Du, Jerry Y.; Lu, Amanda; Dempsey, Molly; Herring, John A.; Kim, Harry K.W.

doi:10.1097/bpo.0b013e3182a05dc1

Cited by 51 publications

(41 citation statements)

References 32 publications

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“…Contrast-enhanced MR images, processed using a subtraction technique, were used to determine the area of synovial enhancement. (11) For the contrast MRI, administration of gadoteridol (0.2 mL/kg at 0.5 mmol/mL; maximum dose 20 mL or 10 mmol) was followed by the acquisition of fat-suppressed coronal T1-weighted images. The precontrast images were subtracted from the postcontrast images to obtain the subtraction images, which increase the conspicuity of the synovial membrane enhancement.…”

Section: Mrimentioning

confidence: 99%

Legg-Calvé-Perthes Disease Produces Chronic Hip Synovitis and Elevation of Interleukin-6 in the Synovial Fluid

Kamiya

Yamaguchi

Adapala

et al. 2015

Journal of Bone and Mineral Research

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Legg-Calvé-Perthes disease (LCPD) is a childhood hip disorder of ischemic osteonecrosis of the femoral head. Hip joint synovitis is a common feature of LCPD, but the nature and pathophysiology of the synovitis remain unknown. The purpose of this study was to determine the chronicity of the synovitis and the inflammatory cytokines present in the synovial fluid at an active stage of LCPD. Serial MRI was performed on 28 patients. T2-weighted and gadolinium-enhanced MR images were used to assess synovial effusion and synovial enhancement (hyperemia) over time. A multiple-cytokine assay was used to determine the levels of 27 inflammatory cytokines and related factors present in the synovial fluid from 13 patients. MRI analysis showed fold increases of 5.0 AE 3.3 and 3.1 AE 2.1 in the synovial fluid volume in the affected hip compared to the unaffected hip at the initial and the last follow-up MRI, respectively. The mean duration between the initial and the last MRI was 17.7 AE 8.3 months. The volume of enhanced synovium on the contrast MRI was increased 16.5 AE 8.5 fold and 6.3 AE 5.6 fold in the affected hip compared to the unaffected hip at the initial MRI and the last follow-up MRI, respectively. In the synovial fluid of the affected hips, IL-6 protein levels were significantly increased (LCPD: 509 AE 519 pg/mL, non-LCPD: 19 AE 22 pg/mL; p ¼ 0.0005) on the multi-cytokine assay. Interestingly, IL-1b and TNF-a levels were not elevated. In the active stage of LCPD, chronic hip synovitis and significant elevation of IL-6 are produced in the synovial fluid. Further studies are warranted to investigate the role of IL-6 on the pathophysiology of synovitis in LCPD and how it affects bone healing.

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Section: Mrimentioning

confidence: 99%

Legg-Calvé-Perthes Disease Produces Chronic Hip Synovitis and Elevation of Interleukin-6 in the Synovial Fluid

Kamiya

Yamaguchi

Adapala

et al. 2015

Journal of Bone and Mineral Research

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“…Yapılan başka bir çalışmada, LCP olgularında erken evrede femur başı epifizinde perfüzyon MR ile tespit edilen avaskülarite yaygınlığı ile, iki yıllık takip sonunda radyografik olarak izlenen femur başı deformasyonu yaygınlığının korele olduğu gösterilmiştir. [18] Perfüzyon MR tetkikinde, konvansiyonel sekansların yanı sıra kontrast öncesi yağ baskılı T1-A sekansı ile görüntüleme yapıldıktan sonra i.v. gadolinyum (0,2 ml/kg -0,5 mmol/ml -maks 20 ml) enjeksiyonu yapılarak, dinamik olarak, ardışık sü-relerde koronal yağ baskılı T1-A görüntüler alınır.…”

Section: Perfüzyon Mrunclassified

Legg-Calvé-Perthes hastalığında MR görüntüleme

Özen¹,

Sanal²,

Yıldız³

2017

TOTBID

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“…There is a correlation between the percentage of residual perfusion of the epiphysis and the level of the infusion index at this early stage and the evolution towards the Herring classification (which occurs later). A low residual percentage and a low perfusion index correlated with a greater deformation of the femoral head at 2 years of mean recoil (25,26). An increase in Apparent Diffusion Coefficient (ADC) and Diffusion Weighted Imaging of the femoral metaphysis relative to the contralateral (healthy) hip appears to be related to a more severe Herring stage (27).…”

Section: Mrimentioning

confidence: 99%

Legg-Calv�-Perthes disease: classifications and prognostic factors

Rampal

Clément

Solla

2017

ccmbm

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SummaryIntroduction. Legg-Calvé-Perthes Disease (LCPD) represents idiopathic avascular necrosis of femoral head in pediatric population. Indications for treatment depend mostly on prognosis about femoral head sphericity and hip congruence at the end of growth. The aim of this review is to highline prognostic factors of LCPD. Methods. Bibliographic search in PubMed allowed selection of 33 articles concerning prognostic factors and/or classification of LCPD. Conclusion. Clinical factors of poor prognosis are overweight, female sex, age exceeding 6 years old, and lack of hip abduction. Radiologically, Herring's classification is consensual because of its high prognostic value and very good reproducibility. The other signs of femoral head "at-risk" and the assessment of the reduction in abduction of the femoral head in the acetabulum are also prognostic of late evolution. MRI seems to be a future tool in assessing the fate of hips in LCPD. It is likely that a better understanding of LCPD etiology would precise the prognosis of this disease.

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MR Perfusion Index as a Quantitative Method of Evaluating Epiphyseal Perfusion in Legg-Calve-Perthes Disease and Correlation With Short-term Radiographic Outcome

Abstract: Prognostic level II.

Cited by 51 publications

References 32 publications

Legg-Calvé-Perthes Disease Produces Chronic Hip Synovitis and Elevation of Interleukin-6 in the Synovial Fluid

Legg-Calvé-Perthes Disease Produces Chronic Hip Synovitis and Elevation of Interleukin-6 in the Synovial Fluid

Legg-Calvé-Perthes hastalığında MR görüntüleme

Legg-Calv�-Perthes disease: classifications and prognostic factors

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