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


Ontology type: schema:ScholarlyArticle     


Article Info

DATE

2015-07

AUTHORS

Christoph A. Agten, Filippo Del Grande, Sandro F. Fucentese, Samuel Blatter, Christian W. A. Pfirrmann, Reto Sutter

ABSTRACT

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 (11.8 cm(2) vs. 37.7 cm(2)) and PD (16.8 cm(2) vs. 18.9 cm(2)), 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. More... »

PAGES

2184-2193

Identifiers

URI

http://scigraph.springernature.com/pub.10.1007/s00330-015-3596-4

DOI

http://dx.doi.org/10.1007/s00330-015-3596-4

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1042213151

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/25627351


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40 schema:description 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 (11.8 cm(2) vs. 37.7 cm(2)) and PD (16.8 cm(2) vs. 18.9 cm(2)), 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.
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