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MDCT useful for evaluating hip dysplasia cartilage loss

Multidetector computed tomography showed substantially higher interobserver reliability compared to MRI.

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Arthrography performed using multidetector computed tomography accurately detects cartilage loss in hip dysplasia patients and may be more reliable than MRI, according to a study by Japanese researchers.

Takashi Nishii, MD, and colleagues at the Osaka University Medical School compared the diagnostic accuracy of the two imaging methods for evaluating acetabular and femoral cartilage lesions. Their study included 20 hips among 18 patients with acetabular dysplasia either without osteoarthritis (OA) or with early stage OA before having undergone pelvic osteotomy, according to the study.

All patients underwent both multidetector computed tomography (MDCT) arthrography and fat-suppressed 3D fast-spoiled gradient-echo MRI. The researchers compared diagnoses made by two independant observers to the results of arthroscopic examinations to determine the efficacy of the two imaging methods, according to the study.

The researchers found that MDCT arthrography had higher sensitivity, specificity and accuracy rates than MRI for detecting cartilage disorders and for diagnosing cartilage loss.

Using MRI to detect cartilage disorders of grade 1 or higher, observer one had 49% sensitivity and 89% specificity and observer two had 67% sensitivity and 76% specificity. Using MDCT arthrography, observer one had 67% sensitivity and 89% specificity and observer two had 67% sensitivity and 82% specificity.

For detecting cartilage loss of grade 2 or higher using MRI, observer one had 47% sensitivity and 92% specificity; observer two had 53% sensitivity and 87% specificity. But using MDCT arthrography, observer one had 70% sensitivity and 93% specificity, while observer two had 79% sensitivity and 94% specificity, according to the study.

“MDCT arthrography provided significantly higher sensitivity in the detection of grade 2 or higher lesions than MRI for both observers,” the authors said, noting moderate interobserver agreement using MRI (kappa=0.53) but substantial agreement using MDCT (kappa=0.78).

“A high incidence of cartilage abnormalities in patients with hip dysplasia indicates the need for more sensitive imaging methods than those previously used. Our study suggests that MDCT arthrography may become a prominent method for imaging patients with hip dysplasia, including precise assessment of osteoarthritis progression, adequate planning of surgery and accurate monitoring of the effects of drug treatment and surgery,” Nishii said in a press release.

The study was published in the American Journal of Roentgenology.

For more information:

• Nishii T, Tanaka H, Nakanishi K, et al. Fat-suppressed 3D spoiled gradient-echo MRI and MDCT arthrography of articular cartilage in patients with hip dysplasia. AJR Am J Roentgenol. 2005;185:379-385.