Feasibility of Magnetic Resonance Angiography in Patients With Legg-Calve-Perthes Disease
Citações na Scopus
2
Tipo de produção
article
Data de publicação
2021
Título da Revista
ISSN da Revista
Título do Volume
Editora
LIPPINCOTT WILLIAMS & WILKINS
Autores
LEAO FILHO, Hilton
DEMPSEY, Molly
KIM, Harry K. W.
Citação
JOURNAL OF PEDIATRIC ORTHOPAEDICS, v.41, n.9, p.E774-E779, 2021
Resumo
Background: The etiology of Legg-Calve-Perthes disease (LCPD) remains unknown; however, interruption of medial circumflex femoral artery (MCFA) supply to the femoral head is the key pathogenic factor. The main purpose of this study is to determine the feasibility of using magnetic resonance angiography (MRA) to evaluate the course of the MCFA in the normal and affected hips of patients with unilateral LCPD. Methods: We analyzed 24 patients with unilateral LCPD using a time-resolved imaging of contrast kinetics magnetic resonance angiography (TRICKS-MRA). The course of the MCFA was divided into 4 segments in the coronal plane and in 3 segments in the axial plane, based on its location with respect to the femoral neck. The visibility of each segment was studied in the normal and affected sides. The segments were defined as not visible when no contrast was seen within the vessel lumen or visible when the lumen was partially or completely visualized with contrast. The statistical analysis was done using the chi(2) test. Results: TRICKS-MRA provided well-defined images of the first 2 segments of the MCFA on both the normal and affected sides of patients with LCPD (P=1). In half of the patients, the third segment was also visible using TRICKS-MRA on both sides (P=1). The fourth segment of the MCFA, which was the ascending lateral epiphyseal segment, was not visible on either side (P=0.49). No significant difference was found between the normal and affected hips in terms of visibility of the 4 segments of the MCFA using TRICKS-MRA. Anastomosis of the MCFA with the inferior gluteal artery was found in 3 hips (2 hips with LCPD and 1 normal hip). Conclusions: TRICKS-MRA provides well-defined images of the arterial supply to the proximal femoral epiphysis in children with LCPD, presenting a noninvasive and radiation-free alternative to conventional angiography. However, the TRICKS-MRA method used did not allow visualization of the ascending lateral epiphyseal segment of MCFA in the affected and the contralateral normal side. We believe that further advancement of this noninvasive imaging technique may open new opportunities for research aimed at evaluating the vascular supply of the femoral head in children.
Palavras-chave
Legg-Calve-Perthes disease, magnetic resonance angiography, time-resolved imaging of contrast kinetics (TRICKS)
Referências
- Atsumi T, 2000, J BONE JOINT SURG BR, V82B, P392, DOI 10.1302/0301-620X.82B3.10193
- Atsumi T., 2001, CLIN ORTHOP RELA MAY, V386, P210
- Baunin C, 2014, ORTHOP TRAUMATOL-SUR, V100, P317, DOI 10.1016/j.otsr.2013.12.025
- CHUNG SMK, 1976, J BONE JOINT SURG AM, V58, P961, DOI 10.2106/00004623-197658070-00011
- Crock HV., 1980, CLIN ORTHOP RELAT R, V152, P17
- De Carmargo FP., 1984, CLIN ORTHOP RELAT R, V191, P216
- De Godoy RM., 1988, THESIS U SAO PAULO B
- Dillman JR, 2009, AM J ROENTGENOL, V193, P1394, DOI 10.2214/AJR.09.2444
- Du J, 2013, J PEDIATR ORTHOPED, V33, P707, DOI 10.1097/BPO.0b013e3182a05dc1
- Grist TM, 2012, J MAGN RESON IMAGING, V36, P1273, DOI 10.1002/jmri.23646
- Hailer YD, 2018, CLIN ORTHOP RELAT R, V476, P1055, DOI 10.1007/s11999.0000000000000214
- Hailer YD, 2010, PEDIATRICS, V125, pE1308, DOI 10.1542/peds.2009-2935
- Joseph B, 2003, J PEDIATR ORTHOPED, V23, P601, DOI 10.1097/01241398-200309000-00006
- Joseph B, 2003, J PEDIATR ORTHOPED, V23, P590, DOI 10.1097/01241398-200309000-00005
- Kim HKW, 2014, J BONE JOINT SURG AM, V96A, P1152, DOI 10.2106/JBJS.M.01221
- Kim HKW, 2011, ORTHOP CLIN N AM, V42, P285, DOI 10.1016/j.ocl.2011.04.007
- Kim HKW, 2010, J AM ACAD ORTHOP SUR, V18, P676, DOI 10.5435/00124635-201011000-00005
- Kramer JH, 2012, MAGN RESON IMAGING C, V20, P761, DOI 10.1016/j.mric.2012.08.002
- Laine JC, 2018, J AM ACAD ORTHOP SUR, V26, P526, DOI 10.5435/JAAOS-D-16-00856
- Lamer S, 2002, PEDIATR RADIOL, V32, P580, DOI 10.1007/s00247-002-0732-5
- Malayeri AA, 2016, J AM COLL RADIOL, V13, P237, DOI 10.1016/j.jacr.2015.11.009
- Mathur M, 2020, RADIOGRAPHICS, V40, P153, DOI 10.1148/rg.2020190110
- McDonald JS, 2020, MAGN RESON IMAGING C, V28, P497, DOI 10.1016/j.mric.2020.06.001
- Merlini L, 2010, PEDIATR RADIOL, V40, P318, DOI 10.1007/s00247-009-1468-2
- Norman D, 1998, INT J EXP PATHOL, V79, P173
- Perry DC, 2012, PEDIATRICS, V130, pE126, DOI 10.1542/peds.2011-3269
- Phemister DB, 1921, ARCH SURG-CHICAGO, V2, P221, DOI 10.1001/archsurg.1921.01110050039003
- Swan JS, 2002, RADIOLOGY, V225, P43, DOI 10.1148/radiol.2251011292
- THERON J, 1980, RADIOLOGY, V135, P81, DOI 10.1148/radiology.135.1.7360984
- Yoo WJ, 2016, RADIOLOGY, V279, P562, DOI 10.1148/radiol.2015151105
- Yoo WJ, 2011, CLIN ORTHOP RELAT R, V469, P2881, DOI 10.1007/s11999-011-1931-x
- Zhang HL, 2005, AM J ROENTGENOL, V184, P938, DOI 10.2214/ajr.184.3.01840938