title: Contrast-enhanced fat saturation magnetic resonance imaging for studying the pathophysiology of osteonecrosis of the hips.
abstract: We imaged 75 hips in 40 patients using fat saturation technique before and after intravenous injection of contrast (0.1 mmol/kg gadolinium diethylene triamine penta-acetic acid, Gd-DTPA). Eighteen hips in 11 patients were determined to be osteonecrotic, either by pathologic or clinical examination. In the osteonecrotic hips, three distinct patterns of enhancement were found: (I) focal area outlined by brightly enhancing rim (7 hips); (II) diffuse enhancement in the femoral head and neck extending into the femoral shaft (3 hips); and (III) a combination of patterns I and II (8 hips). Our data support the hypothesis that early nontraumatic osteonecrosis is associated with hyperemia and/or an increase in capillary permeability rather than acute devascularization, and that diffuse marrow edema is the initial finding in early nontraumatic osteonecrosis.
authors.affiliation: Department of Radiology, St. Joseph's Hospital, Phoenix, Arizona.
authors.forename: K C
authors.initials: KC
authors.lastname: Li
authors.forename: P
authors.initials: P
authors.lastname: Hiette
mesh_terms: D002199:Capillary Permeability / Q000502:physiology; D003287:Contrast Media; D005260:Female; D005269:Femur / Q000098:blood supply; D005271:Femur Head Necrosis / Q000175:diagnosis* / Q000503:physiopathology; D005682:Gadolinium; D019786:Gadolinium DTPA; D006621:Hip Joint / Q000473:pathology*; D006801:Humans; D006940:Hyperemia / Q000503:physiopathology; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D008875:Middle Aged; D009942:Organometallic Compounds; D004369:Pentetic Acid
chemical_list: D003287:Contrast Media; D009942:Organometallic Compounds; D004369:Pentetic Acid; D005682:Gadolinium; D019786:Gadolinium DTPA