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Magn Reson Med. 2018 Mar;79(3):1628-1637. doi: 10.1002/mrm.26807. Epub 2017 Jun 22.

Off-resonance based assessment of metallic wear debris near total hip arthroplasty.

Author information

1
Department of Radiology, Medical College of Wisconsin, Milwaukee, Wisconsin, USA.
2
Division of Radiology and Imaging, Hospital for Special Surgery, New York, New York, USA.
3
Anatomic Pathology and Orthopaedic Surgery, Cleveland Clinic, Cleveland, Ohio, USA.
4
MR Applications and Workflow, GE Healthcare, Milwaukee, Wisconsin, USA.

Abstract

PURPOSE:

The presence of metallic debris near total hip arthroplasty can have a significant impact on longitudinal patient management. Methods for magnetic resonance imaging-based quantification of metallic debris near painful total hip replacements are described and applied to cohorts of symptomatic and control subject cases.

METHODS:

A combination of metal artifact reduction, off-resonance mapping, off-resonance background removal, and spatial clustering methods are utilized to quantify off-resonance signatures in cases of suspected metallosis. These methods are applied to a cohort of symptomatic hip arthroplasties composed of cobalt-chromium alloys. Magnetostatic simulations and theoretical principles are used to illuminate the potential sources of the measured off-resonance effects. Reported metrics from histological tissue assays extracted during surgical revision procedures are also correlated with the proposed magnetic resonance imaging-based quantification results.

RESULTS:

The presented methods identified quantifiable metallosis signatures in more than 70% of the symptomatic and none of the control cases. Preliminary correlations of the MR data with direct histological evaluation of retrieved tissue samples indicate that the observed off-resonance effect may be related to tissue necrosis.

CONCLUSIONS:

Magnetostatic simulations, theoretical principles, and preliminary histological trends suggest that disassociated cobalt is the source of the observed off-resonance signature. Magn Reson Med 79:1628-1637, 2018. © 2017 International Society for Magnetic Resonance in Medicine.

KEYWORDS:

metal implants; metallosis; susceptibility quantification; total hip arthroplasty

PMID:
28643347
PMCID:
PMC5741538
DOI:
10.1002/mrm.26807
[Indexed for MEDLINE]
Free PMC Article

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