Dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) for the prediction of non-union consolidation

• Verfasst von: Fischer, Christian [VerfasserIn]
• Verfasst von: Nissen, Mareike [VerfasserIn]
• Verfasst von: Schmidmaier, Gerhard [VerfasserIn]
• Verfasst von: Bruckner, Thomas [VerfasserIn]
• Verfasst von: Kauczor, Hans-Ulrich [VerfasserIn]
• Verfasst von: Weber, Marc-André [VerfasserIn]
• Titel: Dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) for the prediction of non-union consolidation
• Verf.angabe: Christian Fischer, Mareike Nissen, Gerhard Schmidmaier, Thomas Bruckner, Hans-Ulrich Kauczor, Marc-André Weber
• E-Jahr: 2017
• Jahr: 9 January 2017
• Umfang: 7 S.
• Fussnoten: Gesehen am 21.08.2019
• Titel Quelle: Enthalten in: Injury
• Ort Quelle: Amsterdam [u.a.] : Elsevier Science, 1969
• Jahr Quelle: 2017
• Band/Heft Quelle: 48(2017), 2, Seite 357-363
• ISSN Quelle: 1879-0267
• DOI: doi:10.1016/j.injury.2017.01.021
• Datenträger: Online-Ressource
• Sprache: eng
• Sach-SW: Body mass index
• Sach-SW: Diamond concept
• Sach-SW: Imaging
• Sach-SW: Magnetic resonance imaging
• Sach-SW: Masquelet
• Sach-SW: Non-union
• Sach-SW: NUSS
• Sach-SW: Perfusion
• K10plus-PPN: 1581041233

Abstract

Introduction: Non-union perfusion can be visualized with dynamic contrast-enhanced (DCE) MRI. This study evaluated DCE-MRI to predict non-union consolidation after surgery and detect factors that affect bone healing. Materials and methods: Between 2010 and 2015 non-union perfusion was prospectively quantified in 205 patients (mean age, 51.5 years, 129 men, 76 women) before intervention and at 6, 12, 26, 52 and more weeks follow-up. DCE-MRI results were related to the osseous consolidation, the ability to predict successful outcome was estimated by ROC analysis. The relevance of the body mass index (BMI) and the non-union severity score (NUSS) to the healing process was assessed. Results: Tibial (n=99) and femoral (n=76) non-unions were most common. Consolidation could be assessed in 169 patients, of these 103 (61%) showed eventual healing and demonstrated higher perfusion than in failed consolidation at 6 (p=0.0226), 12 (p=0.0252) and 26 (p=0.0088) weeks follow-up. DCE-MRI at 26 weeks follow-up predicted non-union consolidation with a sensitivity of 75% and a specificity of 87% (false classification rate 19%). Higher BMI (p=0.041) and NUSS (p<0.0001) were associated with treatment failure. Conclusions: DCE-MRI perfusion analysis after non-union surgery predicts successful outcome and could facilitate the decision of early intervention. NUSS and BMI are important prognostic factors concerning consolidation.