Protocol for MRI of the Hips After Spica Cast Placement
Protocol for MRI of the Hips After Spica Cast Placement
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DOI：
10.1097/bpo.0b013e31825a23e4
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发表时间：
2012-07-01
影响因子：
1.7
通讯作者：
Harcke, H. Theodore
中科院分区：
文献类型：
--
作者：
Gould, Sharon W.;Grissom, Leslie E.;Harcke, H. Theodore
背景：在减少发育性髋关节脱位中，股骨头在髋臼内的同心放置是关键。磁共振成像（MRI）是评估复位是否充分的有效方法，但由于检查时间较长，可能需要镇静。MRI也比其他成像方式更昂贵。我们的目标是提供一个MRI协议，不需要镇静，可以在< 15 minutes.Methods进行：我们回顾性分析了34个连续的MRI研究，没有镇静后，在24个发育性髋关节发育不良患者的spica石膏放置。采用多种技术进行MRI检查。使用的序列进行了对比度，分辨率，和运动artifaction.Results：百分之九十七的研究是诊断，虽然18%的检查有显着的运动伪影。分析了7个序列。T2加权快速自旋回波序列具有最好的总体评分，并且在< 3分钟内进行。T1和脂肪抑制T2加权快速自旋回波序列的评分也不好，也需要< 3分钟。单次激发快速自旋回波序列由于对比度和分辨率降低而得分不高，尽管采集时间较短，为20至40秒。三维（3D）梯度恢复成像由于对比度较低而评分较差，并且由于采集时间较长（约4分钟）而增加了运动。冠状面和轴向的序列令人满意地评估股骨头的位置内acetablum.Conclusions：MRI是一个有用的工具，在评估髋关节没有辐射暴露，没有镇静的婴儿和幼儿后spica铸造安置。轴向和冠状位T2快速自旋回波MRI序列均提供了出色的解剖定义和所需的
Background: In reduction of hip displacement in developmental dysplasia, concentric placement of the femoral head within the acetabulum is key. Magnetic resonance imaging (MRI) is an effective modality to assess the adequacy of the reduction, but sedation may be required due to the length of the examination. MRI is also more expensive than other imaging modalities. Our goal was to provide an MRI protocol that does not require sedation and can be performed in < 15 minutes.Methods: We retrospectively reviewed 34 consecutive MRI studies performed without sedation after spica cast placement in 24 developmental hip dysplasia patients. The MRI examinations were performed with a variety of techniques. Sequences used were evaluated for contrast, resolution, and motion artifact.Results: Ninety-seven percent of studies were diagnostic, although 18% of examinations had significant motion artifact. Seven sequences were analyzed. T2-weighted fast spin echo sequences had the best overall scores and were performed in < 3 minutes. T1 and fat-suppressed T2-weighted fast spin echo sequences did not score as well, and also required < 3 minutes. Single-shot fast spin echo sequences scored poorly due to decreased contrast and resolution, despite shorter acquisition times of 20 to 40 seconds. Three-dimensional (3D) gradient recovery imaging scored poorly due to lower contrast and increased motion due to longer acquisition times of approximately 4 minutes. Both coronally and axially oriented sequences satisfactorily assessed femoral head position within the acetabulum.Conclusions: MRI is a useful tool in evaluating the hips without radiation exposure and without sedation in infants and toddlers after spica cast placement. Both axial and coronal T2 fast spin echo MRI sequences provided excellent anatomic definition and required