Quantitative DCE-MRI assessment of femoral head epiphysis perfusion after closed reduction in developmental dysplasia of the hip.

IF 2.2 3区医学 Q2 ORTHOPEDICS

Skeletal Radiology Pub Date : 2026-06-01 Epub Date: 2026-02-16 DOI:10.1007/s00256-026-05170-x

Hong Wang, Shu Wang, Shan Lin, Hui Li

{"title":"Quantitative DCE-MRI assessment of femoral head epiphysis perfusion after closed reduction in developmental dysplasia of the hip.","authors":"Hong Wang, Shu Wang, Shan Lin, Hui Li","doi":"10.1007/s00256-026-05170-x","DOIUrl":null,"url":null,"abstract":"Objective: To investigate femoral head epiphysis perfusion via dynamic contrast-enhanced MRI (DCE-MRI) in children with developmental dysplasia of the hip (DDH) after closed reduction, assessing correlations between perfusion parameters and enhancement grades, and their utility in identifying post-reduction ischemia.Materials and methods: Children with DDH undergoing closed reduction and plaster fixation were evaluated with MRI (conventional sequences, T1 mapping, and DCE-MRI) within 3 days post-procedure. Femoral head perfusion was evaluated using DCE-MRI subtraction, graded as 0 (normal), 1 (asymmetric decrease), 2 (focal decrease), or 3 (complete decrease). Perfusion parameters (Ktrans, Kep, Ve) were quantified in the epiphyseal ROI. The correlation with perfusion grades and diagnostic value for ischemia was analyzed.Results: The study included 58 DDH patients (116 hips; 68 dislocated, 48 normal). Among the dislocated side of DDH, although a marginal age difference was observed among the groups (P = 0.053), no significant differences were found in sex distribution or Tönnis grade (P > 0.05). Significant perfusion parameter differences were observed across enhancement grades (all P < 0.05), with Ktrans showing greatest discrimination (H = 89.769). Ktrans and Kep correlated negatively with enhancement grade (r = -0.883 and -0.608, respectively; both P < 0.001). For ischemia detection (grade ≥ 2), Ktrans demonstrated superior diagnostic accuracy (AUC = 0.959, cutoff = 0.028 min-1) versus Kep (AUC = 0.811) and Ve (AUC = 0.628). Performance further improved for grade 3 ischemia (Ktrans AUC = 0.992, cutoff = 0.010 min-1).Conclusion: Ktrans < 0.010 min-1 on DCE-MRI signals post-reduction ischemia in dislocated femoral heads, inversely correlating with enhancement grade. This threshold may help identify high-risk patients requiring close monitoring or intervention.","PeriodicalId":21783,"journal":{"name":"Skeletal Radiology","volume":" ","pages":"1337-1346"},"PeriodicalIF":2.2000,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Skeletal Radiology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s00256-026-05170-x","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2026/2/16 0:00:00","PubModel":"Epub","JCR":"Q2","JCRName":"ORTHOPEDICS","Score":null,"Total":0}

引用次数: 0

Abstract

Objective: To investigate femoral head epiphysis perfusion via dynamic contrast-enhanced MRI (DCE-MRI) in children with developmental dysplasia of the hip (DDH) after closed reduction, assessing correlations between perfusion parameters and enhancement grades, and their utility in identifying post-reduction ischemia.

Materials and methods: Children with DDH undergoing closed reduction and plaster fixation were evaluated with MRI (conventional sequences, T1 mapping, and DCE-MRI) within 3 days post-procedure. Femoral head perfusion was evaluated using DCE-MRI subtraction, graded as 0 (normal), 1 (asymmetric decrease), 2 (focal decrease), or 3 (complete decrease). Perfusion parameters (K^trans, K_ep, V_e) were quantified in the epiphyseal ROI. The correlation with perfusion grades and diagnostic value for ischemia was analyzed.

Results: The study included 58 DDH patients (116 hips; 68 dislocated, 48 normal). Among the dislocated side of DDH, although a marginal age difference was observed among the groups (P = 0.053), no significant differences were found in sex distribution or Tönnis grade (P > 0.05). Significant perfusion parameter differences were observed across enhancement grades (all P < 0.05), with K^trans showing greatest discrimination (H = 89.769). K^trans and K_ep correlated negatively with enhancement grade (r = -0.883 and -0.608, respectively; both P < 0.001). For ischemia detection (grade ≥ 2), K^trans demonstrated superior diagnostic accuracy (AUC = 0.959, cutoff = 0.028 min^-1) versus K_ep (AUC = 0.811) and V_e (AUC = 0.628). Performance further improved for grade 3 ischemia (K^trans AUC = 0.992, cutoff = 0.010 min^-1).

Conclusion: K^trans < 0.010 min^-1 on DCE-MRI signals post-reduction ischemia in dislocated femoral heads, inversely correlating with enhancement grade. This threshold may help identify high-risk patients requiring close monitoring or intervention.

查看原文本刊更多论文

髋关节发育不良闭合复位后股骨头骨骺灌注的定量DCE-MRI评估。

目的：通过动态对比增强MRI （DCE-MRI）研究发育性髋关节发育不良（DDH）儿童闭合复位后股骨头骨骺灌注情况，评估灌注参数与增强分级之间的相关性，以及它们在识别复位后缺血中的应用。材料和方法：手术后3天内用MRI（常规序列、T1定位和DCE-MRI）评估行闭合复位和石膏固定的DDH患儿。股骨头灌注通过DCE-MRI减影评估，评分为0（正常）、1（不对称减少）、2（局灶性减少）或3（完全减少）。在ROI骨骺区定量灌注参数（Ktrans, Kep, Ve）。分析其与灌注等级的相关性及对缺血的诊断价值。结果：研究纳入58例DDH患者（116髋，68髋脱位，48髋正常）。DDH脱位侧组间年龄差异不大（P = 0.053），性别分布及Tönnis分级差异无统计学意义（P < 0.05）。各增强等级灌注参数差异显著（所有P反式差异最大（H = 89.769））。Ktrans和Kep与增强分级呈负相关（r分别为-0.883和-0.608），P trans的诊断准确率（AUC = 0.959, cut - off = 0.028 min-1）均优于Kep （AUC = 0.811）和Ve （AUC = 0.628）。3级缺血时性能进一步提高（Ktrans AUC = 0.992，截止时间= 0.010 min-1）。结论：Ktrans -1对脱位股骨头缺血复位后DCE-MRI信号的影响与增强分级呈负相关。这个阈值可能有助于识别需要密切监测或干预的高危患者。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Skeletal Radiology 医学-核医学

CiteScore

4.40

自引率

9.50%

发文量

253

审稿时长

3-8 weeks

期刊介绍： Skeletal Radiology provides a forum for the dissemination of current knowledge and information dealing with disorders of the musculoskeletal system including the spine. While emphasizing the radiological aspects of the many varied skeletal abnormalities, the journal also adopts an interdisciplinary approach, reflecting the membership of the International Skeletal Society. Thus, the anatomical, pathological, physiological, clinical, metabolic and epidemiological aspects of the many entities affecting the skeleton receive appropriate consideration. This is the Journal of the International Skeletal Society and the Official Journal of the Society of Skeletal Radiology and the Australasian Musculoskelelal Imaging Group.