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Dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) for the prediction of non-union consolidation

Introduction: Non-union perfusion can be visualized with dynamic contrast-enhanced (DCE) MRI. This study evaluated DCE-MRI to predict non-union consolidation after surgery and detect factors that affect bone healing. Materials and methods: Between 2010 and 2015 non-union perfusion was prospectively...

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Hauptverfasser: Fischer, Christian (VerfasserIn) , Nissen, Mareike (VerfasserIn) , Schmidmaier, Gerhard (VerfasserIn) , Bruckner, Thomas (VerfasserIn) , Kauczor, Hans-Ulrich (VerfasserIn) , Weber, Marc-André (VerfasserIn)
Dokumenttyp: Article (Journal)
Sprache:Englisch
Veröffentlicht: 9 January 2017
In: Injury
Year: 2017, Jahrgang: 48, Heft: 2, Pages: 357-363
ISSN:1879-0267
DOI:10.1016/j.injury.2017.01.021
Online-Zugang:Verlag, Volltext: http://dx.doi.org/10.1016/j.injury.2017.01.021
Verlag, Volltext: http://www.sciencedirect.com/science/article/pii/S0020138317300219
Volltext
Verfasserangaben:Christian Fischer, Mareike Nissen, Gerhard Schmidmaier, Thomas Bruckner, Hans-Ulrich Kauczor, Marc-André Weber
Beschreibung
Zusammenfassung:Introduction: Non-union perfusion can be visualized with dynamic contrast-enhanced (DCE) MRI. This study evaluated DCE-MRI to predict non-union consolidation after surgery and detect factors that affect bone healing. Materials and methods: Between 2010 and 2015 non-union perfusion was prospectively quantified in 205 patients (mean age, 51.5 years, 129 men, 76 women) before intervention and at 6, 12, 26, 52 and more weeks follow-up. DCE-MRI results were related to the osseous consolidation, the ability to predict successful outcome was estimated by ROC analysis. The relevance of the body mass index (BMI) and the non-union severity score (NUSS) to the healing process was assessed. Results: Tibial (n=99) and femoral (n=76) non-unions were most common. Consolidation could be assessed in 169 patients, of these 103 (61%) showed eventual healing and demonstrated higher perfusion than in failed consolidation at 6 (p=0.0226), 12 (p=0.0252) and 26 (p=0.0088) weeks follow-up. DCE-MRI at 26 weeks follow-up predicted non-union consolidation with a sensitivity of 75% and a specificity of 87% (false classification rate 19%). Higher BMI (p=0.041) and NUSS (p<0.0001) were associated with treatment failure. Conclusions: DCE-MRI perfusion analysis after non-union surgery predicts successful outcome and could facilitate the decision of early intervention. NUSS and BMI are important prognostic factors concerning consolidation.
Beschreibung:Gesehen am 21.08.2019
Beschreibung:Online Resource
ISSN:1879-0267
DOI:10.1016/j.injury.2017.01.021

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