Dynamic gadolinium-enhanced subtraction MR imaging--a simple technique for the early diagnosis of Legg-Calvé-Perthes disease: preliminary results.
OBJECTIVE
To determine whether the simple technique of dynamic gadolinium-enhanced subtraction MR imaging, which is available on standard MR units, can detect ischemia of the femoral head in children with early Legg-Calvé-Perthes disease (LCP).


METHODS
Bone perfusion of eight hips in four patients (mean age 7.5 years) was studied using dynamic gadolinium-enhanced subtraction MR imaging at the onset of proven LCP (with initial negative plain films). Enhancement of subtracted images was compared with that on standard MR images and with bone scintigraphy findings.


RESULTS
Subtraction MR imaging depicted ischemia as a widespread absence of enhancement and was in good agreement with bone scintigraphy. The subtraction technique improved the sensitivity and the specificity of MR imaging in two children. Furthermore, subtraction MR imaging allowed recognition of the pattern of early reperfusion.


CONCLUSIONS
Our preliminary results indicate that dynamic gadolinium-enhanced subtraction MRI is a simple and promising means of early recognition of ischemia in LCP.
Sebag
G
G
Department of Pediatric Radiology, Robert Debre Hospital, Paris, France.
Ducou Le Pointe
H
H
Klein
I
I
Maiza
D
D
Mazda
K
K
Bensahel
H
H
Hassan
M
M
D002648:Child; D002675:Child, Preschool; D003287:Contrast Media; D005260:Female; D005682:Gadolinium; D006621:Hip Joint / Q000000981:diagnostic imaging / Q000473:pathology; D006801:Humans; D007873:Legg-Calve-Perthes Disease / Q000175:diagnosis* / Q000000981:diagnostic imaging; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008536:Meglumine; D009942:Organometallic Compounds; D011859:Radiography; D011877:Radionuclide Imaging; D012680:Sensitivity and Specificity; D013382:Subtraction Technique
D003287:Contrast Media; D009942:Organometallic Compounds; D008536:Meglumine; D005682:Gadolinium; C072417:gadoterate meglumine