Hyun-joo Kim MD, Presenter: Nothing to Disclose

Myung Jin Shin, Abstract Co-Author: Nothing to Disclose

Ji Hyeon Cha MD, Abstract Co-Author: Nothing to Disclose

Byeong-Kyoo Choi, Abstract Co-Author: Nothing to Disclose

Sang Hoon Lee, Abstract Co-Author: Nothing to Disclose

Hye Won Chung MD, Abstract Co-Author: Nothing to Disclose

To assess the clinical significance of magnetic resonance imaging (MRI) with gadolinium enhancement in the evaluation of avascular necrosis (AVN) of the hip after core decompression and autologous bone marrow transplantation (BMT)

We reviewed MRI with gadolinium enhancement and clinical record of 59 hips in 53 patients with AVN of the hip, treated by core decompression and autologous BMT from January 2003 to October 2006. All hips were categorized into two groups according to symptom relief or not. Pre- and post BMT MRI findings were compared in terms of: (a) Steinberg’s stage of AVN of the hip; (b) percentage of the AVN area; (c) changes in enhancement pattern of the AVN area, such as nodularity or irregular enhancement; (d) presence of bone marrow edema around AVN area. We calculated statistical significance of these factors.

Post BMT MRI was done every six months. Mean follow up interval was 481 days (99~1141 days). There were improvement of symptom in 45 hips and persistent symptom in 14 hips. Pre BMT stages of AVN of the hip were as follows; 5 stage I, 50 stage II and 4 stage III. There was no regression of stage of AVN in femoral head. Three stage I hips progressed to stage II and one to stage III. 27 stage II hips remained same stage, 11 hips progressed to stage III, and two hips to stage IV and V, each. There was no significant statistical difference according to the changes in stage, patterns of contrast enhancement, difference in percentage of necrotic area and presence of bone marrow edema on pre BMT MRI (p>0.05). There was a correlation in presence of bone marrow edema before and after BMT (p=0.001, Fisher’s exact test ). 20 hips with persistent or newly developed bone marrow edema on follow up MRI had hip pain more frequently than 13 hips with improvement of bone marrow edema (p=0.013, Fisher’s exact test, Odds ratio=12).

MRI with gadolinium enhancement has a role as a method of post BMT follow up of AVN of the hip. The hips with bone marrow edema had persistent symptom more frequently.

Pre- and post BMT MRI with contrast enhancement of AVN of the hip can be very informative in the evaluation of post BMT changes.

Kim, H, Shin, M, Cha, J, Choi, B, Lee, S, Chung, H, Clinical Significance of Magnetic Resonance Imaging with Gadolinium Enhancement in the Evaluation of Avascular Necrosis of the Hip after Core Decompression and Autologous Bone Marrow Transplantation.  Radiological Society of North America 2007 Scientific Assembly and Annual Meeting, November 25 - November 30, 2007 ,Chicago IL. http://archive.rsna.org/2007/5002904.html