Feasibility and safety of perfusion MRI for Legg-Calvé-Perthes disease

Study Conducted By The International Perthes Study Group

Research output: Contribution to journalArticle

7 Citations (Scopus)

Abstract

Background: Recent studies have suggested that perfusion magnetic resonance imaging (pMRI) using gadolinium contrast and a subtraction technique can provide useful prognostic information in Legg-Calvé-Perthes disease (LCPD) and allow earlier stratification for outcome. There are, however, sparse data available regarding the feasibility and safety of these studies in children. The purpose of this study was to collect this information across multiple centers using pMRI for LCPD.

Methods: We retrospectively reviewed a consecutive series of patients with confirmed or suspected LCPD who had undergone pMRI at 1 of 5 large tertiary-care children's hospitals in the United States, UK, and Mexico. Demographic information, type of contrast administered, and requirement for sedation or anesthesia were noted. Records were scrutinized for adverse events associated with the pMRI protocol.

Results: Over the study period, 165 patients underwent 298 pMRI studies. The median age at the time of imaging was 8.6 years (range, 2.5to 16.9 y). A total of 252 scans (85%) were performed for a known diagnosis of LCPD, whereas 46 were performed for a suspected diagnosis. Ninety-two of the 298 (31%) pMRIs required sedation, 48 (16%) required general anesthesia, and 122 (41%) were facilitated by video goggles only. The remaining 36 patients (12%) had their studies performed without additional measures. The ages of patients requiring sedation (mean, 7.2±2.4 y) and anesthesia (mean, 7.7±2.3 y) were significantly younger than those patients requiring neither (mean, 10.2±2.3 y, P<0.001). Four patients (1.3%) reported nausea or vomiting as a result of sedation. Two patients (0.7%) had complications from intravenous cannulation (pull out, difficult access). One child (0.3%) had nausea/ vomiting as a result of contrast administration. There were no serious adverse events as a result of the pMRI protocol; specifically none of nephrogenic systemic fibrosis, anaphylaxis, or death.

Conclusions: pMRI is a safe and feasible imaging technique for LCPD. Almost half of our patients required either sedation or general anesthesia to complete the study.

Original languageEnglish (US)
Pages (from-to)679-682
Number of pages4
JournalJournal of Pediatric Orthopaedics
Volume34
Issue number7
StatePublished - 2014

Fingerprint

Legg-Calve-Perthes Disease
Magnetic Resonance Angiography
Perfusion
Safety
General Anesthesia
Nausea
Vomiting
Anesthesia
Nephrogenic Fibrosing Dermopathy
Subtraction Technique
Eye Protective Devices
Gadolinium
Feasibility Studies
Anaphylaxis
Tertiary Healthcare
Mexico
Catheterization
Demography

Keywords

  • Gadolinium
  • LCPD
  • Legg-Calvé-Perthes disease
  • Perfusion MRI
  • Safety

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Orthopedics and Sports Medicine

Cite this

Study Conducted By The International Perthes Study Group (2014). Feasibility and safety of perfusion MRI for Legg-Calvé-Perthes disease. Journal of Pediatric Orthopaedics, 34(7), 679-682.

Feasibility and safety of perfusion MRI for Legg-Calvé-Perthes disease. / Study Conducted By The International Perthes Study Group.

In: Journal of Pediatric Orthopaedics, Vol. 34, No. 7, 2014, p. 679-682.

Research output: Contribution to journalArticle

Study Conducted By The International Perthes Study Group 2014, 'Feasibility and safety of perfusion MRI for Legg-Calvé-Perthes disease', Journal of Pediatric Orthopaedics, vol. 34, no. 7, pp. 679-682.
Study Conducted By The International Perthes Study Group. Feasibility and safety of perfusion MRI for Legg-Calvé-Perthes disease. Journal of Pediatric Orthopaedics. 2014;34(7):679-682.
Study Conducted By The International Perthes Study Group. / Feasibility and safety of perfusion MRI for Legg-Calvé-Perthes disease. In: Journal of Pediatric Orthopaedics. 2014 ; Vol. 34, No. 7. pp. 679-682.
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abstract = "Background: Recent studies have suggested that perfusion magnetic resonance imaging (pMRI) using gadolinium contrast and a subtraction technique can provide useful prognostic information in Legg-Calv{\'e}-Perthes disease (LCPD) and allow earlier stratification for outcome. There are, however, sparse data available regarding the feasibility and safety of these studies in children. The purpose of this study was to collect this information across multiple centers using pMRI for LCPD.Methods: We retrospectively reviewed a consecutive series of patients with confirmed or suspected LCPD who had undergone pMRI at 1 of 5 large tertiary-care children's hospitals in the United States, UK, and Mexico. Demographic information, type of contrast administered, and requirement for sedation or anesthesia were noted. Records were scrutinized for adverse events associated with the pMRI protocol.Results: Over the study period, 165 patients underwent 298 pMRI studies. The median age at the time of imaging was 8.6 years (range, 2.5to 16.9 y). A total of 252 scans (85{\%}) were performed for a known diagnosis of LCPD, whereas 46 were performed for a suspected diagnosis. Ninety-two of the 298 (31{\%}) pMRIs required sedation, 48 (16{\%}) required general anesthesia, and 122 (41{\%}) were facilitated by video goggles only. The remaining 36 patients (12{\%}) had their studies performed without additional measures. The ages of patients requiring sedation (mean, 7.2±2.4 y) and anesthesia (mean, 7.7±2.3 y) were significantly younger than those patients requiring neither (mean, 10.2±2.3 y, P<0.001). Four patients (1.3{\%}) reported nausea or vomiting as a result of sedation. Two patients (0.7{\%}) had complications from intravenous cannulation (pull out, difficult access). One child (0.3{\%}) had nausea/ vomiting as a result of contrast administration. There were no serious adverse events as a result of the pMRI protocol; specifically none of nephrogenic systemic fibrosis, anaphylaxis, or death.Conclusions: pMRI is a safe and feasible imaging technique for LCPD. Almost half of our patients required either sedation or general anesthesia to complete the study.",
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AU - Study Conducted By The International Perthes Study Group

AU - Sankar, Wudbhav N.

AU - Thomas, Simon

AU - Castañeda, Pablo

AU - Hong, Tiffany

AU - Shore, Benjamin J.

AU - Kim, Harry K W

PY - 2014

Y1 - 2014

N2 - Background: Recent studies have suggested that perfusion magnetic resonance imaging (pMRI) using gadolinium contrast and a subtraction technique can provide useful prognostic information in Legg-Calvé-Perthes disease (LCPD) and allow earlier stratification for outcome. There are, however, sparse data available regarding the feasibility and safety of these studies in children. The purpose of this study was to collect this information across multiple centers using pMRI for LCPD.Methods: We retrospectively reviewed a consecutive series of patients with confirmed or suspected LCPD who had undergone pMRI at 1 of 5 large tertiary-care children's hospitals in the United States, UK, and Mexico. Demographic information, type of contrast administered, and requirement for sedation or anesthesia were noted. Records were scrutinized for adverse events associated with the pMRI protocol.Results: Over the study period, 165 patients underwent 298 pMRI studies. The median age at the time of imaging was 8.6 years (range, 2.5to 16.9 y). A total of 252 scans (85%) were performed for a known diagnosis of LCPD, whereas 46 were performed for a suspected diagnosis. Ninety-two of the 298 (31%) pMRIs required sedation, 48 (16%) required general anesthesia, and 122 (41%) were facilitated by video goggles only. The remaining 36 patients (12%) had their studies performed without additional measures. The ages of patients requiring sedation (mean, 7.2±2.4 y) and anesthesia (mean, 7.7±2.3 y) were significantly younger than those patients requiring neither (mean, 10.2±2.3 y, P<0.001). Four patients (1.3%) reported nausea or vomiting as a result of sedation. Two patients (0.7%) had complications from intravenous cannulation (pull out, difficult access). One child (0.3%) had nausea/ vomiting as a result of contrast administration. There were no serious adverse events as a result of the pMRI protocol; specifically none of nephrogenic systemic fibrosis, anaphylaxis, or death.Conclusions: pMRI is a safe and feasible imaging technique for LCPD. Almost half of our patients required either sedation or general anesthesia to complete the study.

AB - Background: Recent studies have suggested that perfusion magnetic resonance imaging (pMRI) using gadolinium contrast and a subtraction technique can provide useful prognostic information in Legg-Calvé-Perthes disease (LCPD) and allow earlier stratification for outcome. There are, however, sparse data available regarding the feasibility and safety of these studies in children. The purpose of this study was to collect this information across multiple centers using pMRI for LCPD.Methods: We retrospectively reviewed a consecutive series of patients with confirmed or suspected LCPD who had undergone pMRI at 1 of 5 large tertiary-care children's hospitals in the United States, UK, and Mexico. Demographic information, type of contrast administered, and requirement for sedation or anesthesia were noted. Records were scrutinized for adverse events associated with the pMRI protocol.Results: Over the study period, 165 patients underwent 298 pMRI studies. The median age at the time of imaging was 8.6 years (range, 2.5to 16.9 y). A total of 252 scans (85%) were performed for a known diagnosis of LCPD, whereas 46 were performed for a suspected diagnosis. Ninety-two of the 298 (31%) pMRIs required sedation, 48 (16%) required general anesthesia, and 122 (41%) were facilitated by video goggles only. The remaining 36 patients (12%) had their studies performed without additional measures. The ages of patients requiring sedation (mean, 7.2±2.4 y) and anesthesia (mean, 7.7±2.3 y) were significantly younger than those patients requiring neither (mean, 10.2±2.3 y, P<0.001). Four patients (1.3%) reported nausea or vomiting as a result of sedation. Two patients (0.7%) had complications from intravenous cannulation (pull out, difficult access). One child (0.3%) had nausea/ vomiting as a result of contrast administration. There were no serious adverse events as a result of the pMRI protocol; specifically none of nephrogenic systemic fibrosis, anaphylaxis, or death.Conclusions: pMRI is a safe and feasible imaging technique for LCPD. Almost half of our patients required either sedation or general anesthesia to complete the study.

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KW - LCPD

KW - Legg-Calvé-Perthes disease

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KW - Safety

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