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Topic:

Developmental Dysplasia of the Hip

Issue:

Hip

Category:

Developmental

Title:

Comparison of Contrast-enhanced Ultrasound and Contrast-enhanced Magnetic Resonance Imaging in the Assessment of Infant Hip Perfusion and Prediction of Proximal Femoral Growth Disturbance Following Closed and Open Reduction for Developmental Dysplasia of the Hip: A Preliminary Study

Author:

Matheney, Travis MD; Shore, Benjamin MD, MPH; Miller, Patricia MS; Barnewolt, Carol MD; Kim, Young-Jo MD, PhD; Paltiel, Harriet MD

Journal:

Journal of Pediatric Orthopaedics

Date:

April 2024

Reference:

44(4):p e335-e343, DOI: 10.1097/BPO.0000000000002614

Level Of Evidence:

II

# of Patients:

18

Study Type:

Retrospective analysis

Location:

Single-center study (exact location not mentioned)

Summary:

This study compared contrast-enhanced ultrasound (CEUS) and contrast-enhanced magnetic resonance imaging (CEMRI) for assessing hip perfusion and predicting proximal femoral growth disturbance (PFGD) after surgical treatment for developmental dysplasia of the hip.

Methods:

Retrospective analysis of infant patients undergoing closed or open hip reduction (2012–2019). Intraoperative CEUS and postoperative CEMRI were used to assess femoral epiphyseal perfusion. Perfusion status was categorized as normal, partially decreased, or globally decreased for both modalities. Patients were followed for a minimum of 2 years to assess the development of PFGD.

Exclusions:

Not specified

Results:

Substantial agreement in perfusion status between CEUS and CEMRI (α = 0.74). PFGD developed in 3 hips (17%). CEUS and CEMRI were comparable in detecting PFGD: CEUS: Accuracy 83%, Sensitivity 100%, Specificity 80%. CEMRI: Accuracy 78%, Sensitivity 100%, Specificity 73%. For globally decreased perfusion: CEUS: Accuracy 94%, Sensitivity 67%, Specificity 100%. CEMRI: Accuracy 89%, Sensitivity 67%, Specificity 93%.

Conclusions:

CEUS is a viable, accurate intraoperative method for assessing hip perfusion. It is comparable to CEMRI in visualizing hip perfusion and predicting PFGD after hip reduction. Further prospective studies are recommended to confirm these findings.

Relevance:

Limitations:

Perspective:

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