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MRI-, CT-based 3D models had similar diagnostic values for femoroacetabular impingement
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MRI-based 3D models of the hip joint had excellent correlation with and may replace CT-based 3D models for both diagnostic parameters and range of motion values in patients with femoroacetabular impingement, according to published results.
Till D. Lerch, MD, and colleagues compared CT- and MRI-based osseous 3D models of 31 hips in 26 patients with symptomatic femoroacetabular impingement. Researchers obtained 3D-CT scans of the entire pelvis and the distal femoral condyles and performed preoperative MRI of the hip.
Results showed a difference of less than 1 mm between MRI- and CT-based 3D models for the proximal femur and the acetabulum. Researchers found an excellent correlation for range of motion values and for six diagnostic parameters between CT and MRI. The 3D models had a mean absolute difference of approximately 1.9° for flexion, 2.6° for extension, 2° for inclination and 1° for anteversion, according to results. In CT- and MRI-based 3D range of motion analyses, researchers noted no differences in the location of impingement in 12 of 12 acetabular and in 11 of 12 femoral clock-face positions.
“3D MRI can replace 3D CT for dynamic impingement simulation for patients with [femoroacetabular impingement] FAI,” Lerch told Healio.com/Orthopedics. “This could be used for 3D preoperative planning for patients undergoing hip arthroscopy.” – by Casey Tingle
Disclosures: Lerch reports no relevant financial disclosures. Please see the study for a list of all other authors’ relevant financial disclosures.
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Ali Bajwa, MPhil (Cantab), GCSRT (Harvard), MBBS, MRCSEd, MSc Orth, DSEM (UK&I), MFSEM (UK), FRCS Tr & Orth
I read the study by Lerch and colleagues from Bern University Hospital, Switzerland with great interest regarding patient-specific 3D MRI-based simulation of hip compared with CT scan-based simulation in patients with FAI.
Arthroscopic and open-surgery for FAI are great tools for correcting bony deformities and repairing soft tissue damage. In recent years, CT-based 3D simulation of FAI has been used for preoperative planning. The current study shows MRI-based simulation models of FAI model are reasonably accurate, as the difference in acetabulum and proximal femur models was <1 mm compared with CT-based simulation. It seems to me that MRI-based simulation will certainly eliminate patient radiation exposure, however, it is also likely to help diagnose the soft tissue component of impingement, delineate soft tissue injury and evaluate femoral head blood supply, thus providing a more comprehensive planning tool.
Villar Bajwa Practice
Cambridge, United Kingdom
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