BROOKLYN 3

MRI USER GROUP

Gareth LEEPER

Sat 31st Aug 2013

Session 2 / Talk 2

10:55 – 11:06

ABSTRACTMagnetic Resonance Imaging of the Hip under traction. One of the more difficult aspects of diagnosing causes of hip pain on MRI is to clearly identify early degenerative change in the cartilage. The application of traction to the limb being imaged allows for expansion of the joint and excellent delineation of cartilage margins of both the femoral head and acetabulum. It will only work once the joint has been decompressed following an arthrographic procedure. We have been performing Hip arthrograms using this technique for 3 months with some success. It is dependent on patient co-operation and good staff technique. The resultant images in successful cases are excellent

Fatal A TractionFatal A Traction

Gareth LeeperGareth LeeperManager of MRI ServicesManager of MRI Services

Christchurch Radiology GroupChristchurch Radiology Group

Femoral !!!

Initial setupInitial setup

Attaching leg traction deviceAttaching leg traction device

At CRG we have been applying At CRG we have been applying traction to our Hip Arthrograms with traction to our Hip Arthrograms with

some successsome success

20cm FOV 288x288 4mm 20cm FOV 288x288 4mm20cm FOV 288x288 3mm

Imaging performed in additionImaging performed in addition

Measuring Femoral rotation:Measuring Femoral rotation:

Schematic diagrams of the right femur and acetabulum show how abnormal femoral antetorsion might contribute to the development of FAI. Left: Markedly reduced femoral

antetorsion with smaller amplitude at internal rotation, which may lead to an increased mec...

Sutter R et al. Radiology doi:10.1148/radiol.12111903

©2012 by Radiological Society of North America

3D Modelling of the upper femur to 3D Modelling of the upper femur to determine Femoral Acetabular Impingementdetermine Femoral Acetabular Impingement

T2 mappingT2 mappingMulti echoes allow demonstration of T2 variations in cartilageMulti echoes allow demonstration of T2 variations in cartilage

Healthy cartilage highly structured matrix low T2 signalHealthy cartilage highly structured matrix low T2 signal

As collagen fibres degenerate water molecules less As collagen fibres degenerate water molecules less restricted higher T2 signal restricted higher T2 signal

Future possibilitiesFuture possibilities

Delayed gadolinium enhanced MRI of Delayed gadolinium enhanced MRI of cartilage (dGEMRIC)cartilage (dGEMRIC)

  Glycosaminoglycans (GAGs) in normal cartilageGlycosaminoglycans (GAGs) in normal cartilage

Negatively charged repel Gadolinium ionsNegatively charged repel Gadolinium ions

T1 map multi inversion technique T1 map multi inversion technique

< GAD = >GAG< GAD = >GAG

Diary Date 2014Diary Date 2014

Please make a note in your diaries / phones todayPlease make a note in your diaries / phones today

NZ MR User Group study day NZ MR User Group study day

Saturday March ??? 2014Saturday March ??? 2014

AucklandAuckland

?? Cardiovascular focus ???? Cardiovascular focus ??

These will be run biannually in Auckland and Christchurch initially but will These will be run biannually in Auckland and Christchurch initially but will consider running them in other centres if demand is high enoughconsider running them in other centres if demand is high enough