Hip imaging of avascular necrosis at 7 Tesla compared with 3 Tesla

• Published in: Skeletal radiology Vol. 43; no. 5; pp. 623 - 632
• Main Authors: Theysohn, J. M., Kraff, O., Theysohn, N., Orzada, S., Landgraeber, S., Ladd, M. E., Lauenstein, T. C.
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer Berlin Heidelberg 01.05.2014; Springer; Springer Nature B.V
• Subjects: Adult; Aged; Comparative analysis; Diagnostic imaging; Female; Femur Head Necrosis - pathology; Hip Joint - pathology; Humans; Image Enhancement - methods; Image Interpretation, Computer-Assisted - methods; Imaging; Magnetic Resonance Imaging - methods; Male; Medical imaging equipment; Medicine; Medicine & Public Health; Middle Aged; Necrosis; Nuclear Medicine; Orthopedics; Pathology; Radiology; Reproducibility of Results; Scientific Article; Sensitivity and Specificity; Ultra-high field; Avascular necrosis; AVN; UHF; MRI; Hip
• ISSN: 0364-2348; 1432-2161; 1432-2161
• DOI: 10.1007/s00256-014-1818-5

Objectives To compare ultra-high field, high-resolution bilateral magnetic resonance imaging (MRI) of the hips at 7 Tesla (T) with 3 T MRI in patients with avascular necrosis (AVN) of the femoral head by subjective image evaluations, contrast measurements, and evaluation of the appearance of imaging abnormalities. Materials and Methods Thirteen subjects with avascular necrosis treated using advanced core decompression underwent MRI at both 7 T and 3 T. Sequence parameters as well as resolution were kept identical for both field strengths. All MR images (MEDIC, DESS, PD/T2w TSE, T1w TSE, and STIR) were evaluated by two radiologists with regard to subjective image quality, soft tissue contrasts, B1 homogeneity (four-point scale, higher values indicating better image quality) and depiction of imaging abnormalities of the femoral heads (three-point scale, higher values indicating the superiority of 7 T). Contrast ratios of soft tissues were calculated and compared with subjective data. Results 7-T imaging of the femoral joints, as well as 3-T imaging, achieved “good” to “very good” quality in all sequences. 7 T showed significantly higher soft tissue contrasts for T2w and MEDIC compared with 3 T (cartilage/fluid: 2.9 vs 2.2 and 3.6 vs 2.6), better detailed resolution for cartilage defects (PDw, T2w, T1w, MEDIC, DESS > 2.5) and better visibility of joint effusions (MEDIC 2.6; PDw/T2w 2.4; DESS 2.2). Image homogeneity compared with 3 T (3.9–4.0 for all sequences) was degraded, especially in TSE sequences at 7 T through signal variations (7 T: 2.1–2.9); to a lesser extent also GRE sequences (7 T: 2.9–3.5). Imaging findings related to untreated or treated AVN were better delineated at 3 T (≤1.8), while joint effusions (2.2–2.6) and cartilage defects (2.5–3.0) were better visualized at 7 T. STIR performed much more poorly at 7 T, generating large contrast variations (1.5). Conclusions 7-T hip MRI showed comparable results in hip joint imaging compared with 3 T with slight advantages in contrast detail (cartilage defects) and fluid detection at 7 T when accepting image degradation medially.