BONE PERFUSION AND ADIPOSITY BEYOND THE NECROTIC ZONE IN FEMORAL HEAD OSTEONECROSIS: A QUANTITATIVE MRI STUDY. Issue 131 (October 2020)

• Record Type: Journal Article
• Authors: Cultot, Aurélie; Norberciak, Laurène; Coursier, Raphaël; Putman, Sophie; Cortet, Bernard; Paccou, Julien; Pascart, Tristan; Budzik, Jean-François
• Is Part Of: European journal of radiology. Issue 131(2020)
• Publication Date: 2020-10
• Subjects: ONFH Osteonecrosis of the femoral head -- qMRI quantitative magnetic resonance imaging -- DCE-MRI Dynamic Contrast Enhanced MRI -- BM bone marrow; Femoral head osteonecrosis -- Dynamic contrast-enhanced magnetic resonance imaging -- Chemical Shift Imaging -- Bone marrow adiposity -- Bone; Medical radiology -- Periodicals; Radiology -- Periodicals; Radiologie médicale -- Périodiques; Medical radiology; Periodicals; 616.075705
• DOI: 10.1016/j.ejrad.2020.109206
• Languages: English
• ISSNs: 0720-048X

Abstract

Graphical abstract: Highlights: Femoral head perfusion is altered beyond the necrotic zone. Femoral head bone marrow adiposity is not altered beyond the necrotic zone. Vascular phenomenon beyond the necrotic zone prevail on bone adiposity modifications. Abstract: Purpose: To describe bone perfusion and adiposity beyond the necrotic zone with quantitative MRI techniques in osteonecrosis of the femoral head (ONFH). Method: In this cross-sectional multicentre study, we recruited patients suffering from late-stage ONFH or hip osteoarthritis. Hip MRI included quantitative MRI sequences: chemical-shift imaging and dynamic contrast-enhanced MRI. We drew regions of interest inside the necrotic zone (inner necrosis and its border) and outside (femoral head, neck and greater trochanter) in ONFH. In the control group, regions of interest were drawn in the femoral head, femoral neck and the greater trochanter. For each region of interest, we measured fat fraction, and calculated semi-quantitative (area under the curve, initial slope) and pharmacokinetic perfusion parameters (Ktrans and Kep ). Results: Thirty-two male adults (mean age 58 ± 9 years, range 38–74 years) were included. Sixteen patients formed the ONFH group and fifteen the control group; one was excluded. In the normal-appearing non-necrotic part of the femoral head, fat fraction was not significantly different in comparison with controls (p = 1), but Ktrans was significantly lower than in controls (0.012 ± 0.018 vs. 0.027 ± 0.045; p = 0.05). This perfusion parameter reflects exchanges between blood microvessels and bone marrow. Conclusions: Our results question the concept of adipose toxicity on the macroscopic scale, and bring up the concept of regional ischemic penumbra that goes beyond the visible necrotic zone. Further studies are required to test these hypotheses in larger populations and earlier disease states.