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Kraus, Mareen Sarah; Notohamiprodjo, Mike; Partovi, Sasan; Sobieh, Ahmed; Baur-Melnyk, Andrea; Hausdorf, Jörg and Grosse, Ulrich (2018): MR arthrography of the hip: diagnostic performance and image quality of 3D-steady state free precession versus 2D turbo spin echo sequences. In: Skeletal Radiology, Vol. 47, No. 6: pp. 811-819

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Abstract

Objective To retrospectively compare the diagnostic performance of isotropic 3D steady-state free precession (3D-SSFP) sequences with 2D turbo spin-echo proton density-weighted fat-saturated (2D-TSE-PD fs) images in hip magnetic resonance arthrography;arthroscopy was a standard of reference. Methods Eighty-one patients with suspected labral tears who underwent hip MR arthrography (3-T scanner) were included. 2D-TSE-PD fs sequences were acquired in three planes and a singular sagittal 3D-SSFP. Labral tears, cartilage pathology and bone marrow were independently assessed by two blinded radiologists using a 5-point Likert scale. Accuracy was determined in 39 patients using invasive arthroscopy. Results Diagnostic confidence of labral and cartilaginous pathologies based on image quality was rated higher for 3D-SSFP (4.5 +/- 0.8;4.35 +/- 0.7;p < 0.0001), but inferior for bone marrow pathology (3.9 +/- 0.7;4.0 +/- 0.7;p < 0.0001). In the arthroscopy patients, similar sensitivity (85.9%) but higher specificity (74.4vs.42.9%) and higher positive and negative predictive values were found in 3D-SSFP of labral and cartilage pathologies. Conclusions 3D-SSFP in hip magnetic resonance arthrography offers increased accuracy in detecting labral and cartilage pathologies compared with 2D-TSE-PD, while reducing the acquisition time. A drawback of 3D-SSFP was the inferior diagnostic confidence for bone marrow evaluation;thus, 3D-SSFP should be combined with conventional 2D-TSE sequences.

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