Share：
Share this content in WeChat
X
[Chinese][PDF]76280
• Clinical Article •
Evaluation of microcirculation perfusion in high-risk necrotic femoral head by DCE-MRI
MA Weili  ZHAO Dewei  WANG Benjie  YANG Song  YANG Pei  CHANG Xiaodan 

Cite this article as: Ma WL, Zhao DW, Wang BJ, et al. Evaluation of microcirculation perfusion in high-risk necrotic femoral head by DCE-MRI. Chin J Magn Reson Imaging, 2019 10(4): 263-267. DOI:10.12015/issn.1674-8034.2019.04.005.


[Abstract] Objective: To evaluate the changes of femoral head microcirculation perfusion in high-risk population of femoral head necrosis and the heterogeneity of femoral head blood perfusion in the normal femoral head by DCE-MRI, providing imaging evidence for ultralearly femoral head necrosis.Materials and Methods: Dynamic contrast-enhanced MRI of the hip was performed in 50 adults (a total of 60 cases of femoral head) with 30 cases experimental group who was high-risk patients with osteonecrosis of the femoral head. Another 30 cases of were selected as normal control group. The region of interest (ROI) was selected in the weight-bearing area (anterosuperior), non-weight-bearing area (inferior) and the central area of the femoral head, and the percentage time-intensity curve (TIC) was drawn to read the maximum percentage of enhancement at first pass (fEmax), maximum percentage of enhancement at first pass (Emax), time to peak (TTP) and other related parameters. Comparison of perfusion parameters between different ROI of normal femoral head and corresponding regions of high-risk population of femoral head necrosis by independent sample t-test. Comparison of perfusion parameters between weight bearing areas, non-weight bearing areas and the center of femoral head using analysis of variance.Results: The Emax of ROI in weight-bearing area, non-weight bearing area of the control group was greater than that of high-risk group of femoral head necrosis (P<0.05). The TTP of ROI in non-load area, centre of high risk group was greater than that of the control group of femoral head necrosis (P<0.05). Another important finding was that the fEmax, Emax varied widely in the control group. fEmax and Emax were significantly greater for the weight-bearing area, the center area than for the non-weight bearing area (P<0.01). There was no significant difference in TTP between different ROI in the control group (P>0.05).Conclusions: The ROI of the patients with high risk of avascular necrosis which was decreased compared with the ROI in corresponding with the normal femoral head; areas with more mechanical load had more blood perfusion. In addition, the perfusion volume of femoral head in high risk population is smaller than that of healthy people. The perfusion time was longer than that of the normal femoral head, and there was blood stasis. Therefore, DCE-MRI can be used to guide clinical practice and prevent avascular necrosis of the femoral head at an early stage.
[Keywords] femoral head necrosis；magnetic resonance imaging；dynamic contrast enhanced；microcirculation；blood perfusion；high risk group

MA Weili Department of Radiology, Affiliated Zhongshan Hospital of Dalian University, Dalian 116001, China

ZHAO Dewei Department of Orthopaedics, Affiliated Zhongshan Hospital of Dalian University, Dalian 116001, China

WANG Benjie Department of Orthopaedics, Affiliated Zhongshan Hospital of Dalian University, Dalian 116001, China

YANG Song Department of Orthopaedics, Affiliated Zhongshan Hospital of Dalian University, Dalian 116001, China

YANG Pei Department of Radiology, the Central Hospital of Wuhan, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430014, China

CHANG Xiaodan* Department of Radiology, Affiliated Zhongshan Hospital of Dalian University, Dalian 116001, China

*Correspondence to: Chang XD, E-mail: 13384111832@163.com

Conflicts of interest   None.

ACKNOWLEDGMENTS  This work was part of National Natural Science Foundation of China No.81672139
Received  2019-01-14
Accepted  2019-02-18
DOI: 10.12015/issn.1674-8034.2019.04.005
Cite this article as: Ma WL, Zhao DW, Wang BJ, et al. Evaluation of microcirculation perfusion in high-risk necrotic femoral head by DCE-MRI. Chin J Magn Reson Imaging, 2019 10(4): 263-267. DOI:10.12015/issn.1674-8034.2019.04.005.

[1]
Xie XH, Wang XL, Yang HL, et al. Steroid-associated osteonecrosis: Epidemiology, pathophysiology, animal model, prevention, and potential treatments (an overview). J Orthop Translat, 2015, 3(2): 58-70.
[2]
Malizos KN, Karantanas AH, Varitimidis SE, et al. Osteonecrosis of the femoral head: etiology, imaging and treatment. Eur J Radiol, 2007, 63(1): 16-28.
[3]
Mont MA, Cherian JJ, Sierra RJ, et al. Nontraumatic osteonecrosis of the femoral head: Where do we stand today? A ten-year update. J Bone Joint Surg Am, 2015, 97(19): 1604-1627.
[4]
Li X, Hu J, Zhen H, et al. Early reversible ischemia of femoral head epiphysis in piglets on gadolinium-enhanced MRI: an experimental study. J Huazhong Univ Sci Technol Med Sci, 2006, 26(4): 482-484.
[5]
Budzik JF, Lefebvre G, Behal H, et al. Bone marrow perfusion measured with dynamic contrast enhanced magnetic resonance imaging is correlated to body mass index in adults. Bone, 2017, 99: 47-52.
[6]
Budzik JF, Lefebvre G, Behal H, et al. Assessment of the zonal variation of perfusion parameters in the femoral head: a 3-T dynamic contrast-enhanced MRI pilot study. Skeletal Radiol, 2018, 47(2): 261-270.
[7]
Nakamura T, Matsumoto T, Nishino M, et al. Early magnetic resonance imaging and histologic findings in a model of femoral head necrosis. Clin Orthop Relat Res, 1997, 334(334): 68-72.
[8]
Schneider T, Drescher W, Becker C. Dynamic gadolinium-enhanced MRI evaluation of porcine femoral head ischemia and reperfusion. Skeletal Radiol, 2003, 32(2): 59-65.
[9]
Tsai SW, Wu PK, Chen CF, et al. Etiologies and outcome of osteonecrosis of the femoral head: Etiology and outcome study in a Taiwan population. J Chin Med Assoc, 2016, 79(1): 39-45.
[10]
Jones LC, Hungerford DS. The pathogenesis of osteonecrosis. Instr Course Lect, 2007, 56(56): 179-196.
[11]
Daldrup HE, Shames DM, Husseini W, et al. Quantification of the extraction fraction for gadopentetate across breast cancer capillaries. Magn Reson Med, 1998, 40(4): 537-543.
[12]
Folkman J, Ingber DE. Angiostatic steroids. Method of discovery and mechanism of action. Ann Surg, 1987, 206(3): 374.
[13]
Hu CG, Chen JC, Liu Q. Mechanism of femoral head necrosis induced by long term glucocorticoid treatment in rabbit model. Chin J Orthop, 2004, 24(6): 359.
[14]
Motomura G, Yamamoto T, Miyanishi K, et al. Combined effects of an anticoagulant and a lipid-lowering agent on the prevention of steroid-induced osteonecrosis in rabbits. Arthritis Rheumatol, 2014, 50(10): 3387-3391.
[15]
Rahmouni A, Montazel JL, Divine M, et al. Bone marrow with diffuse tumor infiltration in patients with lymphoproliferative diseases: dynamic gadolinium-enhanced MR imaging. Radiology, 2003, 229(3): 710.
[16]
Wang Y, Li Y, Mao K, et al. Alcohol-induced adipogenesis in bone and marrow: a possible mechanism for osteonecrosis. Clin Orthop Relat Res, 2003, 410(410): 213-224.
[17]
Cui Q, Wang GJ, Balian G. Pluripotential marrow cells produce adipocytes when transplanted into steroid-treated mice. Connect Tissue Res, 2000, 41(1): 45.
[18]
Tomlinson JJ, Boudreau A, Wu D, et al. Modulation of early human preadipocyte differentiation by glucocorticoids. Endocrinology, 2006, 147(11): 5284-5293.
[19]
Hui S, Ge Z, Cheung W, et al. Elevated adipogenesis of marrow mesenchymal stem cells during early steroid-associated osteonecrosis development. J Orthop Surg Res, 2007, 2(1): 15.
[20]
Wang GJ, Sweet DE, Reger SI, et al. Fat-cell changes as a mechanism of avascular necrosis of the femoral head in cortisone-treated rabbits. J Bone Joint Surg Am, 1977, 59(6): 729-735.
[21]
Cruess RL. Osteonecrosis of bone. Current concepts as to etiology and pathogenesis. Clin Orthop Relat Res, 1986, 208(208): 30.
[22]
Griffith JF, Yeung DK, Tsang PH, et al. Compromised bone marrow perfusion in osteoporosis. J Bone Miner Res, 2008, 23(7): 1068-1075.
[23]
Bluemke DA, Petri M, Zerhouni EA. Femoral head perfusion and composition: MR imaging and spectroscopic evaluation of patients with systemic lupus erythematosus and at risk for avascular necrosis. Radiology, 1995, 197(2): 433-438.
[24]
Griffith JF, Yeung DKW, Leung JCS, et al. Prediction of bone loss in elderly female subjects by MR perfusion imaging and spectroscopy. Eur Radiol, 2011, 21(6): 1160-1169.
[25]
Budzik JF, Lefebvre G, Forzy G, et al. Study of proximal femoral bone perfusion with 3D T1 dynamic contrast-enhanced MRI: a feasibility study. Eur Radiol, 2014, 24(12): 3217-3223.
[26]
Lane L, Villacin A, Bullough P. The vascularity and remodelling of subchondrial bone and calcified cartilage in adult human femoral and humeral heads. An age and stress-related phenomenon. J Bone Joint Surg Br, 1977, 59(3): 272-278.
[27]
Farkas T, Boyd RD, Schaffler MB, et al. Early vascular changes in rabbit subchondral bone after repetitive impulsive loading. Clin Orthop Relat Res, 1987(219): 259-267.
[28]
Scheller EL, Rosen CJ. What's the matter with MAT? Marrow adipose tissue, metabolism, and skeletal health. Ann N Y Acad Sci, 2014, 1311(1): 14-30.
[29]
Niu JL, Wang J, Feng GS, et al. Bone marrow perfusion of the hip evaluated with dynamic contrast-enhanced MRI: The preliminary results. Chin J Med Imaging Technol, 2008, 24(10): 1493-1496.

PREV The value of different diffusion models in the depth of myometrial invasion of stage I endometrial cancer
NEXT Voxel-mirrored homotopic connectivity in adolescents with internet addiction: A resting-state functional magnetic resonance imaging study
  


LINK


Tel & Fax: +8610-67113815    E-mail: editor@cjmri.cn