Pelvic heterotopic ossification: MR imaging characteristics.
OBJECTIVE
To evaluate the magnetic resonance (MR) signal intensity characteristics of pelvic heterotopic ossification (HO) in various stages of maturation.


METHODS
Thirty-six patients with HO proved at computed tomography (CT) (n = 17) or radiography (n = 19) who underwent 1.5-T pelvic MR imaging within 3 months were included. HO was defined at CT or radiography as grade 1, fluid attenuation without calcification at CT; grade 2, calcification; grade 3, immature ossification; or grade 4, mature ossification. The location and MR signal intensity of all HO sites were noted.


RESULTS
HO was determined to be grade 1 at 20 of 141 sites, grade 2 at 39, grade 3 at 30, and grade 4 at 52. With increasing HO grade, the following findings were observed: (a) decreasing T2 signal intensity (grade 1, 70%; grade 2, 58%; grade 3, 44%; grade 4, 4%), (b) increasing fat and cortical bone signal intensity at T1-weighted imaging (grade 1, 0%; grade 2, 3%; grade 3, 13%; grade 4, 86%), and (c) decreasing contrast enhancement (from 100% for grade 1 to 20% for grade 4). Fifteen (88%) patients with CT correlation had HO in the anatomic area of the trochanteric or iliopsoas bursa (55 [60%] of 91 sites).


CONCLUSIONS
With progressive maturity of HO, T2 signal intensity and contrast enhancement decrease, but fat and cortical bone-equivalent signal intensity increases.
Ledermann
Hans Peter
HP
Department of Radiology, Thomas Jefferson University Hospital, Philadelphia, PA, USA. hans-peter.ledermann@gmx.ch
Schweitzer
Mark E
ME
Morrison
William B
WB
D000328:Adult; D000368:Aged; D016009:Chi-Square Distribution; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009999:Ossification, Heterotopic / Q000000981:diagnostic imaging / Q000209:etiology / Q000473:pathology*; D010388:Pelvis / Q000000981:diagnostic imaging / Q000473:pathology*; D012189:Retrospective Studies; D013119:Spinal Cord Injuries / Q000150:complications; D014057:Tomography, X-Ray Computed