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. 2016 Jun;10(3):193-9.
doi: 10.1007/s11832-016-0734-8. Epub 2016 Apr 13.

1.0 s Ultrafast MRI in non-sedated infants after reduction with spica casting for developmental dysplasia of the hip: a feasibility study

Atsushi Fukuda  1 , Kenichi Fukiage  2 , Tohru Futami  2 , Tosiaki Miyati  3
Affiliations

1.0 s Ultrafast MRI in non-sedated infants after reduction with spica casting for developmental dysplasia of the hip: a feasibility study

Atsushi Fukuda et al. J Child Orthop. 2016 Jun.

Abstract

Purpose: The aim of this study was to first develop and use 1.0 s ultrafast magnetic resonance imaging (MRI) to confirm the location of the femoral head in non-sedated infants with developmental dysplasia of the hip (DDH) after reduction with spica cast application in clinical settings.

Methods: The ultrafast acquisition was achieved by employing a balanced steady-state free precession sequence and immobilizing the patient with dedicated sandbags. On completion of the ultrafast MRI study, all infants were sedated for conventional MRI scanning. Two orthopaedic surgeons retrospectively evaluated the image quality, result of the reduction and total MRI study time (including patient immobilization, coil setup, and scanning) in 14 DDHs of 13 infants (one with bilateral DDHs).

Results: Both reviewers stated that there were no motion artefacts for non-sedated infants during the ultrafast MRI and that the quality of both the ultrafast and conventional MRI images were acceptable to assess the femoral head location. Assessment of the reduction procedure resulted in two hips being categorized as 'incomplete reduction' requiring a re-reduction procedure. The total study time of ultrafast and conventional MRI was 6 ± 1 min and 14 ± 3 min, respectively (P < 0.001). No complications due to sedation, such as hypoxia, were reported. The average sedation waiting time was 1 h 25 min ± 34 min.

Conclusion: The ultrafast MRI procedure reported here can be readily employed to confirm the location of the femoral head in infants with DDHs, without the use of any sedation.

Keywords: Developmental dysplasia of the hip; Femoral head location; Reduction; Spica casting; Ultrafast magnetic resonance imaging.

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Figures

Fig. 1
Fig. 1
Photographs of the system used to immobilize patient for magnetic resonance imaging (MRI), before (a) and after immobilization (b). Infants were placed on the examination table and were immobilized using MRI dedicated sandbags and coil
Fig. 2
Fig. 2
Transverse and coronal images by ultrafast (a, b) and conventional MRI (MEDIC) (c, d) of an incomplete reduction of the right hip and reduced left hip in an 8-month-old girl after the reduction procedure. No motion artefact was observed on ultrafast MRI. The results of the transverse and coronal images of the ultrafast MRI examination are similar to those of the conventional MRI examination. White arrow and arrowheads Right triradiate cartilage and incomplete reduction of the right hip, respectively. MEDIC Multiple-echo data image combination
Fig. 3
Fig. 3
a, b Transverse and coronal images of the first ultrafast MRI study revealed an incomplete reduction of the left hip in a 6-month-old girl after gradual reduction with spica casting. White arrow and arrowheads Left triradiate cartilage and incomplete reduction of the left hip, respectively. The re-casting procedure was performed immediately after imaging. c–f Transverse and coronal images of the second ultrafast (c, d) and conventional MRI (MEDIC) (e, f) show successful reduction of the left developmental dysplasia of the hip. No motion artefact was observed on the ultrafast MRI
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References

    1. Grill F, Bensahel H, Canadell J, Dungl P, Matasovic T, Vizkelety T. The Pavlik harness in the treatment of congenital dislocating hip: report on a multicenter study of the European Paediatric Orthopaedic Society. J Pediatr Orthop. 1988;8:1–8. doi: 10.1097/01241398-198801000-00001. - DOI - PubMed
    1. Schoenecker PL, Dollard PA, Sheridan JJ, Strecker WB. Closed reduction of developmental dislocation of the hip in children older than 18 months. J Pediatr Orthop. 1995;15:763–767. doi: 10.1097/01241398-199511000-00008. - DOI - PubMed
    1. Fukiage K, Futami T, Ogi Y, Harada Y, Shimozono F, Kashiwagi N, Takase T, Suzuki S (2015) Ultrasound-guided gradual reduction using flexion and abduction continuous traction for developmental dysplasia of the hip: a new method of treatment. Bone Joint J 97-B:405–411. doi:10.1302/0301-620X.97B3.34287 - PubMed
    1. Gardner RO, Bradley CS, Howard A, Narayanan UG, Wedge JH, Kelley SP (2014) The incidence of avascular necrosis and the radiographic outcome following medial open reduction in children with developmental dysplasia of the hip: a systematic review. Bone Joint J 96-B:279–286. doi:10.1302/0301-620X.96B2.32361 - PubMed
    1. Eberhardt O, Zieger M, Langendoerfer M, Wirth T, Fernandez FF. Determination of hip reduction in spica cast treatment for DDH: a comparison of radiography and ultrasound. J Child Orthop. 2009;3:313–318. doi: 10.1007/s11832-009-0194-5. - DOI - PMC - PubMed