In:
The British Journal of Radiology, British Institute of Radiology, Vol. 93, No. 1105 ( 2020-01), p. 20190738-
Abstract:
To investigate the value of MRI in comparison to single photon emission computed tomography (SPECT)/CT in patients with painful hip arthroplasties. Methods: A prospective, multi-institutional study was performed. Therefore, 35 consecutive patients (21 female, 14 male, mean age 61.8 ± 13.3 years) with 37-painful hip arthroplasties were included. A hip surgeon noted the most likely diagnosis based on clinical examination and hip radiographs. Then, MRI and SPECT/CT of the painful hips were acquired. MRI and SPECT/CT were assessed for loosening, infection, fracture, tendon pathology and other abnormalities. Final diagnosis and therapy was established by the hip surgeon after integration of MRI and SPECT/CT results. The value of MRI and SPECT/CT for diagnosis was assessed with a 3-point scale (1 = unimportant, 2 = helpful, 3 = essential). Results: Loosening was observed in 13/37 arthroplasties (6 shaft only, 6 cup only, 1 combined). Sensitivity, specificity, positive predictive value and negative predictive value for loosening of MRI were 86%/88%/60%/100% and of SPECT/CT 93%/97%/90%/100%, respectively. MRI and SPECT/CT diagnosed infection correctly in two of three patients and fractures in two patients, which were missed by X-ray. MRI detected soft tissue abnormalities in 21 patients (6 bursitis, 14 tendon lesions, 1 pseudotumor), of which only 1 tendon abnormality was accurately detected with SPECT/CT. All 5 arthroplasties with polyethylene wear were correctly diagnosed clinically and with both imaging modalities. MRI and SPECT/CT were judged as not helpful in 0/0%, as helpful in 16%/49% and essential in 84%/51%. Conclusion: In patients with painful hip arthroplasty SPECT/CT is slightly superior to MR in the assessment of loosening. MRI is far superior in the detection of soft tissue, especially tendon pathologies. Advances in knowledge: To our knowledge this is the first prospective, multiinstitutional study which compares MRI with SPECT/CT in painful hip arthroplasties. We found that MRI is far superior in the detection of soft tissue pathologies, whereas SPECT/CT remains slightly superior regarding loosening.
Type of Medium:
Online Resource
ISSN:
0007-1285
,
1748-880X
DOI:
10.1259/bjr.20190738
Language:
English
Publisher:
British Institute of Radiology
Publication Date:
2020
detail.hit.zdb_id:
1468548-6
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