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Radiology, Vol 182, 445-450, Copyright © 1992 by Radiological Society of North America

ARTICLES

Avascular necrosis of the hip: comparison of contrast-enhanced and nonenhanced MR imaging with histologic correlation. Work in progress

B Vande Berg, J Malghem, MA Labaisse, H Noel and B Maldague
Department of Radiology, Louvain University, St-Luc University Hospital, Brussels, Belgium.

In 15 hips with typical signs of avascular necrosis of the femoral head on plain radiographs and magnetic resonance (MR) images, gadolinium- enhanced spin-echo and fat-suppressed MR images were obtained and compared with nonenhanced T1- and T2-weighted images. Both enhanced and nonenhanced areas were consistently detected in the abnormal femoral heads. Enhanced areas showed a low signal intensity (SI) on T1-weighted MR images obtained before contrast material was administered and an intermediate to high SI on T2-weighted images. Nonenhanced areas showed an SI either identical (pattern 1) or hypointense (pattern 2) to that of fat on both sequences. Histologic correlation (six resected femoral heads) helped confirm that enhanced and nonenhanced areas corresponded respectively to viable and necrotic tissue. In most cases, SI analysis of nonenhanced T1- and T2-weighted images allows the differentiation of hypervascularized viable tissue from hypovascularized necrotic tissue of the sequestrum.


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