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