Evaluation of marrow perfusion in the femoral head by dynamic magnetic resonance imaging. Effect of venous occlusion in a dog model.
OBJECTIVE
There is a continuing need for a greater sensitivity of magnetic resonance imaging (MRI) in the diagnosis of avascular necrosis (AVN). Previously, it was demonstrated that a dynamic MRI method, with gadolinium-DTPA (Gd-DTPA) enhancement, can detect acute changes not seen on spin-echo images after arterial occlusion in a dog model. Because venous congestion appears to be a more directly relevant hemodynamic abnormality in a majority of clinical AVN cases, the authors extended the dynamic MRI technique to study changes in venous occlusion.


METHODS
Dynamic MRI of the proximal femur was performed in five adult dogs before and after unilateral ligation of common iliac and lateral circumflex veins. Sixteen sequential gradient-recalled pulse sequence (GRASS) images (time resolution = 45 mseconds, echo time = 9 mseconds, flip angle = 65 degrees) were obtained immediately after a bolus intravenous injection of 0.2 mmol/kg of Gd-DTPA. Simultaneous measurements of regional blood flow were made using the radioactive microsphere method.


RESULTS
After venous ligation, there was a 25% to 45% decrease in the degree of enhancement compared with preligation values on the ligated side. The decrease in cumulative enhancement (integrated over the entire time course) was statistically significant. The occlusion technique was verified by confirming a statistically significant decrease in blood flow determined by the microsphere method.


CONCLUSIONS
Dynamic Gd-DTPA-enhanced fast MRI technique can detect acute changes in bone marrow perfusion due to venous occlusion. This technique may have applications in the early detection of nontraumatic AVN.
Tsukamoto
H
H
Department of Radiology, Johns Hopkins University School of Medicine, Baltimore, Maryland 21205.
Kang
Y S
YS
Jones
L C
LC
Cova
M
M
Herold
C J
CJ
McVeigh
E
E
Hungerford
D S
DS
Zerhouni
E A
EA
D000818:Animals; D001853:Bone Marrow / Q000503:physiopathology*; D003251:Constriction, Pathologic; D003287:Contrast Media; D004285:Dogs; D005271:Femur Head Necrosis / Q000175:diagnosis* / Q000503:physiopathology; D019786:Gadolinium DTPA; D008279:Magnetic Resonance Imaging / Q000379:methods*; D009942:Organometallic Compounds; D004369:Pentetic Acid; D014680:Veins / Q000503:physiopathology*
D003287:Contrast Media; D009942:Organometallic Compounds; D004369:Pentetic Acid; D019786:Gadolinium DTPA