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Gadolinium-enhanced MR imaging demonstrates abduction-caused hip ischemia and its reversal in piglets

  • Caffey Award Paper
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Abstract

Purpose

To determine whether gadoliniumenhanced MR imaging can detect early reversible ischemia of the capital femoral epiphysis and physis induced by hip hyperabduction in piglets.

Materials and methods

Thirteen 1-to 3-week-old piglets were placed in maximal abduction of both hips and studied with dynamic gadolinium-enhanced MR imaging 1–6 h later to assess ischemia of the 26 femoral heads. They were then allowed to ambulate freely for 1 or 7 days, and reimaged in neutral position to assess reperfusion. Enhancement was evaluated on MR images and compared with histologic findings.

Results

Ischemia after hyperabduction developed in all 26 cartilaginous epiphyses and in 85% of the physes. The most frequent abnormality was a sharply marginated nonenhancing area in the anterior part of the femoral head. A smaller area of ischemia developed in the posterior part of the femoral head, adjacent to the acetabular rim. The secondary center of ossification was ischemic in 56% of the hips after 1 h of abduction and in all hips after 4 or 6 h (p=0.02). The overall severity of ischemia was greater with increasing abduction time (p<0.001) and increasing degree of abduction (p<0.01). There was partial reperfusion in 83% of the hips after 1 day of ambulation and complete reperfusion in all 26 hips (100%) after 1 week.

Conclusion

Enhanced MRI detects early ischemia of the epiphyseal and physeal cartilage and the epiphyseal marrow. In piglets, ischemia due to hyperabduction is reversible if corrected within 6 h.

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Authors and Affiliations

  1. Department of Radiology, Children's Hospital and Harvard Medical School, 300 Longwood Avenue, 02115, Boston, MA, USA

    D. Jaramillo, O. L. Villegas-Medina, D. K. Doty, J. R. Dwek & R. V. Mulkern

  2. Department of Orthopaedic Surgery, Children's Hospital and Harvard Medical School, 300 Longwood Avenue, 02115, Boston, MA, USA

    F. Shapiro

  3. Clinical Research Center, Beth Israel Hospital, Boston, Massachusetts, USA

    B. J. Ransil

Authors
  1. D. Jaramillo
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  2. O. L. Villegas-Medina
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  3. D. K. Doty
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  4. J. R. Dwek
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  5. B. J. Ransil
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  6. R. V. Mulkern
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  7. F. Shapiro
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Additional information

Editor's note The publication by Dr. Jaramíllo et al.Gadolinium-enhanced MR imaging demonstrates abduction-caused hip ischemia and its reversal in piglets, represents the 1995 Caffey Award winning paper at The Society for Pediatric Radiólogy annual meeting. This paper will be published in bothPediatric Radiology and theAmerican Journal of Roentgenology in recognition of its award winning excellence. This “joint publication” is an honor andnot a double publication. From now on, each year's Caffey Award winning paper will be so honored in both journals.

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Jaramillo, D., Villegas-Medina, O.L., Doty, D.K. et al. Gadolinium-enhanced MR imaging demonstrates abduction-caused hip ischemia and its reversal in piglets. Pediatr Radiol 25, 578–587 (1995). https://doi.org/10.1007/BF02011824

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  • DOI: https://doi.org/10.1007/BF02011824

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