Metal Artefact Reduction Sequences (MARS) in Magnetic Resonance Imaging (MRI) after Total Hip Arthroplasty (THA) : A non-invasive approach for preoperative differentiation between periprosthetic joint infection (PJI) and aseptic complications?
: A non-invasive approach for preoperative differentiation between periprosthetic joint infection (PJI) and aseptic complications?
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Medientyp:
E-Artikel
Titel:
Metal Artefact Reduction Sequences (MARS) in Magnetic Resonance Imaging (MRI) after Total Hip Arthroplasty (THA) : A non-invasive approach for preoperative differentiation between periprosthetic joint infection (PJI) and aseptic complications?
:
A non-invasive approach for preoperative differentiation between periprosthetic joint infection (PJI) and aseptic complications?
Erschienen:
Springer Science and Business Media LLC, 2022
Erschienen in:BMC Musculoskeletal Disorders
Sprache:
Englisch
DOI:
10.1186/s12891-022-05560-x
ISSN:
1471-2474
Entstehung:
Anmerkungen:
Beschreibung:
<jats:title>Abstract</jats:title><jats:sec>
<jats:title>Background</jats:title>
<jats:p>In the past, radiographic imaging was of minor relevance in the diagnosis of periprosthetic joint infections (PJI). Since metal artefact reduction sequences (MARS) are available, magnetic resonance imaging (MRI) has become a promising diagnostic tool for the evaluation of hip arthroplasty implants. The purpose of the present study was to evaluate the efficacy of MARS-MRI in comparison to established diagnostic tools to distinguish between aseptic failure and PJI.</jats:p>
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<jats:title>Methods</jats:title>
<jats:p>From July 2018 to September 2019, 33 patients classified as having an aseptic joint effusion were recruited into the study. The group included 22 women and 11 men with a mean age of 70.4 ± 13.7 (42–88) years. In the same period, 12 patients were classified as having a PJI. The group consisted of 9 women and 3 men with a mean age of 72.5 ± 10.6 (54–88) years. MARS-MRI was conducted using the optimized parameters at 1.5 T in a coronal and axial STIR (short-tau-inversion recovery), a non-fat-saturated T2 in coronal view and a non-fat-saturated T1 in transverse view in 45 patients with painful hip after total hip arthroplasty (THA). Normally distributed continuous data were shown as mean ± standard deviation (SD) and compared using student's t-test. Non-normally distributed continuous data were shown as mean and compared using the Mann–Whitney U test.</jats:p>
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<jats:title>Results</jats:title>
<jats:p>Synovial layering and muscle edema were significant features of periprosthetic joint infection, with sensitivities of 100% and specifities of 63.0—75.0%. The combined specifity and sensitivity levels of synovial layering and muscular edema was 88.0% and 90.0%. Granulomatous synovitis was a significant feature for aseptic failure, with 90.0% sensitivity and 57.0% specifity.</jats:p>
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<jats:title>Conclusion</jats:title>
<jats:p>MARS-MRI is as suitable as standard diagnostic tools to distinguish between aseptic failure and PJI in patients with THA. Further studies with larger patient numbers have to prove whether MARS-MRI could be integral part of PJI diagnostic.
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