Image quality of hip MR arthrography with intra-articular injection of hyaluronic acid versus gadolinium-based contrast agent in patients with femoroacetabular impingement.

Abstract

OBJECTIVE:

To compare image quality of magnetic resonance arthrography (MRA) of the hip with intra-articular injection of high-viscosity hyaluronic acid (HA-MRA) versus Gd-based contrast agent (Gd-MRA) in patients with femoroacetabular impingement (FAI).

MATERIALS AND METHODS:

Design: single-centre, observational, retrospective, inter-individual, and cross-sectional. FAI patients who underwent HA-MRA (3 mL of high-viscosity HA plus 17 mL of saline) were compared with 37 age- and sex-matched FAI patients who underwent Gd-MRA (20 mL of 2 mmol/L solution of gadopentetate dimeglumine). Two independent blinded radiologists assessed image quality for all sequences (two-dimensional proton density, non-fat-sat axial, fat-sat coronal and sagittal; three-dimensional dual-echo steady state), using a 5-point Likert scale considering separately labrum, cartilage, round ligament, transverse ligament, and capsule. Pearson χ2 and Cohen κ were used.

RESULTS:

The HA-MRA group was composed of 37 patients (23 males, 14 females; median age 38 years), the Gd-MRA group of 37 patients (21 males, 16 females; median age 38 years), without significant difference for age (p = 0.937) and sex (p = 0.636). Image quality did not differ between the two readers for any structure: labrum (p ≥ 0.340), cartilage (p ≥ 0.198), round ligament (p ≥ 0.255), transverse ligament (p ≥ 0.806), and capsule (p ≥ 0.314). Inter-reader agreement (κ) ranged from 0.785 to 1.000.

CONCLUSIONS:

HA-MRA provided an image quality not significantly different from that of Gd-MRA. This may open the possibility of combining MRA and viscosupplementation in one single procedure.

• Authors: Filippo Randelli, Elisabetta Antonia Nocerino, Luca Nicosia, Marco Alì, Caterina Beatrice Monti, Francesco Sardanelli, Alberto Aliprandi
• Journal: Skeletal radiology (Skeletal Radiol) Vol. 49 Issue 6 Pg. 937-944 (Jun 2020) ISSN: 1432-2161 [Electronic] Germany
• PMID: 31915855 (Publication Type: Journal Article, Observational Study)

Chemical References

• Contrast Media
• Hyaluronic Acid
• Gadolinium DTPA

Topics

• Adult
• Contrast Media (administration & dosage)
• Cross-Sectional Studies
• Female
• Femoracetabular Impingement (diagnostic imaging)
• Gadolinium DTPA (administration & dosage)
• Humans
• Hyaluronic Acid (administration & dosage)
• Injections, Intra-Articular
• Magnetic Resonance Imaging (methods)
• Male
• Retrospective Studies