Learning objectives
Jont puncture technique,
contrast medium amount and concentration.
Technique and methodology of hip MRA
Hip MRA anatomy
Appropriate indications
Diagnostic traps of hip MR-arthrography
Background
Despite this widespread adoption and high diagnostic performance MRI ,
there are some areas (e.g.,
the shoulder,
the wrist,
the hip) in which evaluation of the joint space may be suboptimal,mainly due to anatomic conformation of the joint itself.
To overcome these limitations,
diluted Gadolinium-based contrast agents may be injected into the joint space to perform MR-arthrography (MRA),
with the two-fold purpose of distending the joint capsule and making intra-articular structures more visible.
In different settings,
MRA has been demonstrated to increase diagnostic performance of...
Findings and procedure details
Several studies have established that direct MR-arthrography is better than conventional MR to find and characterize lesions at the labrum acetabular and articular capsule-level.
Contrast solution
We usually use commercially avaivalble pre-filled syringe of diluted gadolinium based chelate contrast solution.
The amount of contrast solution is about 20 ml.
Some authors prepare a contrast solution with gadolinium chelate,
saline fluid and 0,1% lidocaine in order to increas patient confort.
Other authors add to the contrast solution iodine based solution in order to perfrom also CT-arthrography....
Conclusion
If you perform MR arthrography of the hip according to established indications, using robust protocols and methodology the MRA exam ensures optimal clinical results.
Personal information
G.
Valeri is the Chief of Radiology Unit of Fermo Hospital,
Fermo,
Italy.
G.
Gismondi and S.
Sabino are staff radiologists of Radiology Unit of Fermo Hospital,
Italy.
A.
Giovagnoni is a full professor of Radiology at UNIVPM,
Ancona,
Italy.
References
1.
Ciarrapico AM,
Ugenti R,
Di Minco L et al (2017) Diagnostic
imaging and spending review: extreme problems call for extreme
measures.
Radiol Med 122:288–293
2.
Symanski JS,
Subhas N,
Babb J,
Nicholson J,
Gyftopoulos S
(2017) Diagnosis of Superior Labrum Anterior-to-Posterior Tears
by Using MR Imaging and MR Arthrography: A Systematic
Review and Meta-Analysis.
Radiology 285:101–113
3.
Sutter R,
Zubler V,
Hoffmann A et al (2014) Hip MRI: how useful
is intraarticular contrast material for evaluating surgically proven
lesions of the labrum and articular...