[MR arthrography of the labrum acetabulare--a radiological-anatomical correlation in 20 cadaveric hips].
OBJECTIVE
To investigate frequency of acetabular labral lesions in elderly hip joints, and to determine sensitivity and specificity of MR arthrography (MRa) for the detection of these abnormalities.


METHODS
Twenty cadaveric hip joints were examined by MRa. For MRa, 15 ml of a solution of iodinated contrast solution (Solutrast 300) and Gd-DTPA (100:1) were injected under fluoroscopic guidance. MR imaging was performed on a 1.5 T MR scanner (Vision, Siemens; FOV 16 cm, matrix 256 x 256, fat-suppressed 3D-FLASH). Multiplanar image reconstructions were done perpendicular to the acetabulum in the oblique-coronal, oblique-axial, and radial planes. The labral specimens were examined macroscopically.


RESULTS
In 12/20 hips (60%), a labral lesion was found on pathologic examination. In 7 specimens, the labrum was partially or completely detached in the weight-bearing superior region. One flap-like variant of the labrum was seen; in 4 hip joints, the labrum was degenerated (one cystic degeneration). Pathologic findings were confirmed by MRa in 8/12 specimens (sensitivity 67%). All degenerated labra were correctly diagnosed on MRa. Three small labral detachments and the flap-like variant were misinterpreted as being normal. There were no false positive findings (specificity 100%). The accuracy was 80%. Labral lesions were seen in 6/8 and in 6/12 of hips with and without osteoarthritis, respectively.


CONCLUSIONS
MRa is well suited to delineate the acetabular labrum and to diagnose labral abnormalities. Detection of small labral detachments and anatomic variants is difficult and requires some experience. Labral lesions are correlated to osteoarthritis of the hip, but may be frequently seen in the elderly without underlying osteoarthritis.
Brossmann
J
J
Klinik für Diagnostische Radiologie, Christian-Albrechts-Universität Kiel. jbrossma@rad.uni-kiel.de
Plötz
G M
GM
Steffens
J C
JC
Hassenpflug
J
J
Heller
M
M
D000077:Acetabulum / Q000000981:diagnostic imaging / Q000473:pathology*; D000368:Aged; D000369:Aged, 80 and over; D002102:Cadaver; D003287:Contrast Media; D005260:Female; D019786:Gadolinium DTPA; D006621:Hip Joint / Q000000981:diagnostic imaging / Q000473:pathology*; D006801:Humans; D007479:Iopamidol; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D008875:Middle Aged; D011859:Radiography; D012680:Sensitivity and Specificity
D003287:Contrast Media; D007479:Iopamidol; D019786:Gadolinium DTPA