Dynamic contrast-enhanced magnetic resonance imaging can assess vascularity within fracture non-unions and predicts good outcome.
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| Title: | Dynamic contrast-enhanced magnetic resonance imaging can assess vascularity within fracture non-unions and predicts good outcome. |
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| Authors: | Schoierer, Oliver1, Bloess, Konstantin2, Bender, Daniel1, Burkholder, Iris3, Kauczor, Hans-Ulrich2, Schmidmaier, Gerhard1, Weber, Marc-André2 MarcAndre.Weber@med.uni-heidelberg.de |
| Source: | European Radiology. Feb2014, Vol. 24 Issue 2, p449-459. 11p. 3 Color Photographs, 1 Black and White Photograph, 6 Charts, 1 Graph. |
| Subjects: | Treatment of fractures, Magnetic resonance imaging, Pharmacokinetics, Medical imaging systems, Healing, Computed tomography |
| Abstract: | Objectives: To prospectively evaluate whether dynamic contrast-enhanced (DCE) MRI can assess vascularity within non-unions and predicts clinical outcome in combination with the clinical Non-Union Scoring System (NUSS). Methods: Fifty-eight patients with non-unions of extremities on CT underwent 3-T DCE MRI. Signal intensity curves obtained from a region-of-interest analysis were subdivided into those with more intense contrast agent uptake within the non-union than in adjacent muscle (vascularised non-union) and those with similar or less contrast uptake. The pharmacokinetic parameters of the Tofts model K, K, iAUC and V were correlated with union at CT 1 year later ( n = 49). Results: Despite inserted osteosynthetic material, DCE parameters could be evaluated in 57 fractures. The sensitivity/specificity of vascularised non-unions as an indicator of good outcome was 83.9 %/50.0 % compared to 96.8 %/33.3 % using NUSS ( n = 49). Logistic regression revealed a significant impact of NUSS on outcome ( P = 0.04, odds ratio = 0.93). At first examination, median iAUC (initial area under the enhancement curve) for the ratio non-union/muscle was 10.28 in patients with good outcome compared with 3.77 in non-responders ( P = 0.023). K, K and V within the non-union were not significantly different initially ( n = 57) or 1 year later ( n = 19). Conclusions: DCE MRI can assess vascularity in fracture non-unions. A vascularised non-union correlates with good outcome. Key points: • Dynamic contrast- enhanced magnetic resonance imaging can assess vascularity within bony non- unions. • Vascularised ununited fractures appear better at 1- year CT than poorly vascularised fractures. • Non- union healing after osteosynthesis or osteoinductive drugs fundamentally requires vascularity. • DCE MRI predicts treatment outcome better than the clinical Non- Union Scoring System. • DCE MRI is clinically feasible to predict treatment outcome in bony non- unions. [ABSTRACT FROM AUTHOR] |
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| Database: | Engineering Source |
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| Header | DbId: egs DbLabel: Engineering Source An: 93646592 AccessLevel: 6 PubType: Academic Journal PubTypeId: academicJournal PreciseRelevancyScore: 0 |
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| Items | – Name: Title Label: Title Group: Ti Data: Dynamic contrast-enhanced magnetic resonance imaging can assess vascularity within fracture non-unions and predicts good outcome. – Name: Author Label: Authors Group: Au Data: <searchLink fieldCode="AR" term="%22Schoierer%2C+Oliver%22">Schoierer, Oliver</searchLink><relatesTo>1</relatesTo><br /><searchLink fieldCode="AR" term="%22Bloess%2C+Konstantin%22">Bloess, Konstantin</searchLink><relatesTo>2</relatesTo><br /><searchLink fieldCode="AR" term="%22Bender%2C+Daniel%22">Bender, Daniel</searchLink><relatesTo>1</relatesTo><br /><searchLink fieldCode="AR" term="%22Burkholder%2C+Iris%22">Burkholder, Iris</searchLink><relatesTo>3</relatesTo><br /><searchLink fieldCode="AR" term="%22Kauczor%2C+Hans-Ulrich%22">Kauczor, Hans-Ulrich</searchLink><relatesTo>2</relatesTo><br /><searchLink fieldCode="AR" term="%22Schmidmaier%2C+Gerhard%22">Schmidmaier, Gerhard</searchLink><relatesTo>1</relatesTo><br /><searchLink fieldCode="AR" term="%22Weber%2C+Marc-André%22">Weber, Marc-André</searchLink><relatesTo>2</relatesTo><i> MarcAndre.Weber@med.uni-heidelberg.de</i> – Name: TitleSource Label: Source Group: Src Data: <searchLink fieldCode="JN" term="%22European+Radiology%22">European Radiology</searchLink>. Feb2014, Vol. 24 Issue 2, p449-459. 11p. 3 Color Photographs, 1 Black and White Photograph, 6 Charts, 1 Graph. – Name: Subject Label: Subjects Group: Su Data: <searchLink fieldCode="DE" term="%22Treatment+of+fractures%22">Treatment of fractures</searchLink><br /><searchLink fieldCode="DE" term="%22Magnetic+resonance+imaging%22">Magnetic resonance imaging</searchLink><br /><searchLink fieldCode="DE" term="%22Pharmacokinetics%22">Pharmacokinetics</searchLink><br /><searchLink fieldCode="DE" term="%22Medical+imaging+systems%22">Medical imaging systems</searchLink><br /><searchLink fieldCode="DE" term="%22Healing%22">Healing</searchLink><br /><searchLink fieldCode="DE" term="%22Computed+tomography%22">Computed tomography</searchLink> – Name: Abstract Label: Abstract Group: Ab Data: Objectives: To prospectively evaluate whether dynamic contrast-enhanced (DCE) MRI can assess vascularity within non-unions and predicts clinical outcome in combination with the clinical Non-Union Scoring System (NUSS). Methods: Fifty-eight patients with non-unions of extremities on CT underwent 3-T DCE MRI. Signal intensity curves obtained from a region-of-interest analysis were subdivided into those with more intense contrast agent uptake within the non-union than in adjacent muscle (vascularised non-union) and those with similar or less contrast uptake. The pharmacokinetic parameters of the Tofts model K, K, iAUC and V were correlated with union at CT 1 year later ( n = 49). Results: Despite inserted osteosynthetic material, DCE parameters could be evaluated in 57 fractures. The sensitivity/specificity of vascularised non-unions as an indicator of good outcome was 83.9 %/50.0 % compared to 96.8 %/33.3 % using NUSS ( n = 49). Logistic regression revealed a significant impact of NUSS on outcome ( P = 0.04, odds ratio = 0.93). At first examination, median iAUC (initial area under the enhancement curve) for the ratio non-union/muscle was 10.28 in patients with good outcome compared with 3.77 in non-responders ( P = 0.023). K, K and V within the non-union were not significantly different initially ( n = 57) or 1 year later ( n = 19). Conclusions: DCE MRI can assess vascularity in fracture non-unions. A vascularised non-union correlates with good outcome. Key points: • Dynamic contrast- enhanced magnetic resonance imaging can assess vascularity within bony non- unions. • Vascularised ununited fractures appear better at 1- year CT than poorly vascularised fractures. • Non- union healing after osteosynthesis or osteoinductive drugs fundamentally requires vascularity. • DCE MRI predicts treatment outcome better than the clinical Non- Union Scoring System. • DCE MRI is clinically feasible to predict treatment outcome in bony non- unions. [ABSTRACT FROM AUTHOR] – Name: AbstractSuppliedCopyright Label: Group: Ab Data: <i>Copyright of European Radiology is the property of Springer Nature and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.</i> (Copyright applies to all Abstracts.) |
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| RecordInfo | BibRecord: BibEntity: Identifiers: – Type: doi Value: 10.1007/s00330-013-3043-3 Languages: – Code: eng Text: English PhysicalDescription: Pagination: PageCount: 11 StartPage: 449 Subjects: – SubjectFull: Treatment of fractures Type: general – SubjectFull: Magnetic resonance imaging Type: general – SubjectFull: Pharmacokinetics Type: general – SubjectFull: Medical imaging systems Type: general – SubjectFull: Healing Type: general – SubjectFull: Computed tomography Type: general Titles: – TitleFull: Dynamic contrast-enhanced magnetic resonance imaging can assess vascularity within fracture non-unions and predicts good outcome. Type: main BibRelationships: HasContributorRelationships: – PersonEntity: Name: NameFull: Schoierer, Oliver – PersonEntity: Name: NameFull: Bloess, Konstantin – PersonEntity: Name: NameFull: Bender, Daniel – PersonEntity: Name: NameFull: Burkholder, Iris – PersonEntity: Name: NameFull: Kauczor, Hans-Ulrich – PersonEntity: Name: NameFull: Schmidmaier, Gerhard – PersonEntity: Name: NameFull: Weber, Marc-André IsPartOfRelationships: – BibEntity: Dates: – D: 01 M: 02 Text: Feb2014 Type: published Y: 2014 Identifiers: – Type: issn-print Value: 09387994 Numbering: – Type: volume Value: 24 – Type: issue Value: 2 Titles: – TitleFull: European Radiology Type: main |
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