Comparison of Pre-Revision Magnetic Resonance Imaging and Operative Findings in Mechanically Assisted Crevice Corrosion in Symptomatic Metal-on-Polyethylene Total Hip Arthroplasties

2017 ◽  
Vol 32 (8) ◽  
pp. 2535-2545 ◽  
Author(s):  
Pavel P. Morozov ◽  
Munib Sana ◽  
Brian J. McGrory ◽  
Steven W. Farraher ◽  
Tod G. Abrahams
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Crevice Corrosion ◽  
Resonance Imaging ◽  
Total Hip ◽  
Operative Findings ◽  
Hip Arthroplasties

The Utility of MRI With Multiacquisition Variable-Resonance Image Combination (MAVRIC) in Diagnosing Deep Total Hip Arthroplasty Infection

2021 ◽  
pp. 155633162110092
Author(s):  
Ashley E. Levack ◽  
Chelsea Koch ◽  
Harold G. Moore ◽  
Michael B. Cross
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
False Positive ◽  
False Positive Rate ◽  
Positive Finding ◽  
Resonance Imaging ◽  
Total Hip ◽  
Positive Rate

Background: The 2010 American Academy of Orthopaedic Surgeons Clinical Practice Guidelines report insufficient evidence to address the diagnostic efficacy of magnetic resonance imaging (MRI) for periprosthetic joint infection (PJI). Questions/Purposes: The purpose of this study was to determine the utility of MRI with multiacquisition variable-resonance image combination (MAVRIC) metal artifact suppression techniques in diagnosing PJI in the setting of total hip arthroplasty (THA). Methods: Multiacquisition variable-resonance image combination MRIs obtained of THAs between November 2012 and November 2016 were queried. Radiology reports were classified as positive (suspicious for infection), negative (no features of infection), or inconclusive (infection cannot be excluded or correlation with aspiration suggested if clinically concerned). Chart review identified cases of deep PJI according to the modified Musculoskeletal Infection Society criteria. Results: Of 2156 MRIs of THAs included, MRI was concerning for infection in 1.8% (n = 39), inconclusive in 1.2% (n = 26), and negative in 97.0% (n = 2091). Deep PJI was identified in 53 (2.5%) patients, 30 of whom (56.6%) had conclusively positive finding on MRI (false-negative rate: 43.4%, sensitivity: 56.6%). Of 2103 aseptic THAs, only 9 (0.4%) MRIs were read as suspicious for infection (false-positive rate: 0.4%; specificity: 99.6%). Conclusion: Magnetic resonance imaging with MAVRIC is a highly specific test for PJI with a low false-positive rate. This indicates that when clinicians are provided with an MRI that unexpectedly suggests infection, a formal evaluation for infection is indicated. In patients with otherwise equivocal diagnostic findings, MRI may help confirm, but not refute, a diagnosis of PJI. Prospective study with more experienced image reviewers may further support the use of MRI in PJI.

Does non-echo-planar diffusion-weighted magnetic resonance imaging have a role in assisting the clinical diagnosis of cholesteatoma in selected cases?

2018 ◽  
Vol 132 (3) ◽  
pp. 207-213 ◽  
Author(s):  
R Nash ◽  
R K Lingam ◽  
D Chandrasekharan ◽  
A Singh
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Imaging Technique ◽  
Single Shot ◽  
Resonance Imaging ◽  
Diffusion Weighted ◽  
Weighted Magnetic Resonance Imaging ◽  
Operative Findings ◽  
Clinical Records ◽  
Echo Planar

AbstractObjective:To determine the diagnostic performance of diffusion-weighted magnetic resonance imaging in the assessment of patients with suspected, but not clinically evident, cholesteatoma.Methods:A retrospective analysis of a prospectively collected database of non-echo-planar diffusion-weighted magnetic resonance imaging studies (using a half-Fourier single-shot turbo-spin echo sequence) was conducted. Clinical records were retrospectively reviewed to determine indications for imaging and operative findings. Seventy-eight investigations in 74 patients with suspected cholesteatoma aged 5.7–79.2 years (mean, 41.7 years) were identified. Operative confirmation was available in 44 ears. Diagnostic accuracy of the imaging technique was calculated using operative findings as a ‘gold standard’. Sensitivity of the investigation was examined via comparison with clinically evident cholesteatoma.Results:The accuracy of diffusion-weighted magnetic resonance imaging in assessment of suspected cholesteatoma was 63.6 per cent. The imaging technique was significantly less accurate in assessment of suspected cholesteatoma than clinically evident disease (p< 0.001).Conclusion:Computed tomography and diffusion-weighted magnetic resonance imaging may be complementary in assessment of suspected cholesteatoma, but should be used with caution, and clinical judgement is paramount.

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