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Perfusion MRI may predict lateral pillar involvement in Legg-Calvé-Perthes disease
Perfusion MRI measurements of the total epiphysis and its lateral third can be predictive of lateral pillar involvement in Legg-Calvé-Perthes disease when obtained early on, according to recently published data.
Researchers studied 29 patients who had gadolinium-enhanced perfusion MRI at the initial/early fragmentation stages of Legg-Calvé-Perthes disease. Mean duration of time from MRI to maximum fragmentation was 8.2 months.
Image analyzing software was utilized to measure the percent perfusion of both the epiphysis and its lateral third. Radiographs obtained at mid-fragmentation stage were used for the lateral pillar classification (A, B or C). Intraclass correlation coefficient (ICC) and logistic regression analyses were also performed.
The ICC for percent perfusion of the lateral third of the epiphysis was 0.90, according to the researchers. In hips with the lateral pillar classified as A, B and C, the mean percent perfusion of the lateral third of the epiphysis was 92%, 68% and 46%, respectively.
When perfusion level was 90% or greater in this area, the odds ratio of the lateral pillar being classified as A was 72. When perfusion level of 55% or less in the lateral third of the epiphysis, the odds ratio of the lateral pillar being classified as C was 33.3.
Similar results were found throughout this cohort for the whole epiphysis, according to the researchers.
Disclosure: See the study for a full list of all authors’ relevant financial disclosures.