T1ρ and T2 mapping for the determination of articular cartilage denaturalization with osteonecrosis of the femoral head: A prospective controlled trial

Background

In the future, biochemical MRI might provide a valuable noninvasive quantitative analysis of the biochemical composition of cartilage in osteonecrosis of the femoral head (ONFH).

Purpose

To investigate the diagnostic performance of T₁ρ and T₂ mapping in cartilage denaturalization with ONFH and to determine the correlation between T₁ρ and T₂ mapping and the Association Research Circulation Osseous (ARCO) stage.

Study Type

Prospective.

Subjects

Forty‐seven patients with ONFH (stage I to III according to the ARCO criteria) and 24 volunteers (control group) were recruited for the prospective study.

Sequence

Conventional MRI, multiple echo recalled gradient echo (MERGE), and T₁ρ and T₂ mapping sequences.

Assessment

Pseudocolor images and MERGE images were combined in the AW4.5 workstation. The region of interest (ROI) of the hip cartilage was 4–6 mm². The sagittal T₁ρ and T₂ mapping values were calculated by the two first authors.

Statistical Tests

One‐way analysis of variance (ANOVA), LSD t‐tests, Pearson correlation analysis, and receiver operator characteristic (ROC) curves. The significance level was set at P < 0.05.

Results

The T₁ρ and T₂ mapping values of the ONFH group were significantly higher than the values of the control group (P = 0.000). Regarding the assessment of the severity of ARCO staging, both T₁ρ (r = 0.66, P = 0.004) and T₂ mapping (r = 0.501, P = 0.002) were positively associated with disease severity. The T₁ρ values were positively correlated with the T₂ mapping values (r = 0.381, P = 0.000). The areas under the curve (AUC) for the T₁ρ and T₂ mapping values were 0.822 and 0.791, respectively. The diagnostic sensitivity and specificity were 72.34% and 70.83% for T₁ρ mapping and 72.34% and 58.33%, respectively, for T₂ mapping.

Data Conclusion

Both T₁ρ and T₂ mapping performed well in diagnosing the cartilage denaturalization in ARCO stage I‐III ONFH patients. T₁ρ mapping had a higher diagnostic sensitivity and specificity than T₂ mapping.

Level of Evidence: 2

Technical Efficacy: Stage 2

J. Magn. Reson. Imaging 2018.

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