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Unicompartmental knee arthroplasty MRI: impact of slice-encoding for metal artefact correction MRI on image quality, findings and therapy decision

Agten, Christoph ; Del Grande, Filippo ; Fucentese, Sandro ; Blatter, Samuel ; Pfirrmann, Christian ; Sutter, Reto

In: European Radiology, 2015, vol. 25, no. 7, p. 2184-2193

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    Titre
    • Unicompartmental knee arthroplasty MRI: impact of slice-encoding for metal artefact correction MRI on image quality, findings and therapy decision
    Auteur
    • Agten, Christoph. Radiology Department, Balgrist University Hospital, Forchstrasse 340, 8008, Zurich, Switzerland
    • Del Grande, Filippo. Radiology, Regional Hospital, Via Tesserete 46, 6900, Lugano, Switzerland
    • Fucentese, Sandro. Faculty of Medicine, University of Zurich, Zurich, Switzerland
    • Blatter, Samuel. Faculty of Medicine, University of Zurich, Zurich, Switzerland
    • Pfirrmann, Christian. Radiology Department, Balgrist University Hospital, Forchstrasse 340, 8008, Zurich, Switzerland
    • Sutter, Reto. Radiology Department, Balgrist University Hospital, Forchstrasse 340, 8008, Zurich, Switzerland
    Type de document
    • Postprint
    Langue
    • Anglais
    Publié dans
    • European Radiology, 2015, vol. 25, no. 7, p. 2184-2193. Springer Berlin Heidelberg
    Autre version électronique
    Identifiant OAI-PMH
    • oai:doc.rero.ch:331744
    Summary
    Objectives: To evaluate the impact of slice-encoding for metal artefact correction (SEMAC) on image quality, findings, and therapy decision in patients with unicompartmental knee arthroplasty (UKA). Methods: Forty-five painful UKAs were examined at 1.5T-MRI (STIR, proton-density(PD)-weighted sequence, each with SEMAC and high-bandwidth). Artefact size, image quality, anatomic depiction, and clinically relevant findings were compared between SEMAC and high-bandwidth (2 readers). In 30 patients, therapy decision was retrospectively assessed by two orthopaedic surgeons without MRI, with high-bandwidth-MRI, and with SEMAC-MRI. Results: SEMAC reduced mean artefact size for STIR (11.8cm2 vs. 37.7cm2) and PD (16.8cm2 vs. 18.9cm2), p < 0.0005 for both comparisons. SEMAC showed more blurring than high-bandwidth, p < 0.0005. STIR-SEMAC revealed more bone marrow oedema (29 vs. 18 patients, p = 0.001, 30 vs. 13 patients, p < 0.0005, for reader 1 and 2 respectively). PD-SEMAC was worse in detecting meniscal lesions (6 missed, p = 0.031, 9 missed, p = 0.004, by reader 1 and 2 respectively) than PD-high-bandwidth. Revision-surgery was chosen in 12 and 11 patients without MRI (surgeon 1 and 2), with high-bandwidth-MRI in 15 and 14 patients, and with SEMAC-MRI in 19 and 14 patients. Conclusions: STIR-SEMAC was useful in detecting bone marrow oedema and influenced the orthopaedic surgeons' decisions towards surgery, while PD-SEMAC showed no clinical benefit. Key Points: • Slice-encoding for metal artefact correction (SEMAC) MRI reduces metal-induced artefact size. • STIR SEMAC detects more bone marrow oedema in painful unicompartmental knee arthroplasty. • STIR SEMAC can help the orthopaedic surgeon with decision making. • PD SEMAC suffers from blurring of images, potentially masking relevant meniscal lesions. • PD SEMAC does not improve cartilage lesion detection in the non-operated compartments.