The Effect of Modality and Landmark Selection on MRI and CT Femoral Torsion Angles.

Abstract:

:Background Assessment of femoral torsion at preoperative hip imaging is commonly recommended. However, it is unclear whether MRI is as accurate as CT and how different methods affect femoral torsion measurements. Purpose To compare MRI- and CT-based assessment of femoral torsion by using four commonly used measurement methods in terms of agreement, reproducibility, and reliability and to compare femoral torsion angles between the four different measurement methods. Materials and Methods This retrospective study evaluated patients with hip pain who underwent CT and 3-T MRI of the hip including sequences of the pelvis and distal condyles between May 2017 and June 2018. The four measurement methods differed regarding the landmark levels for the proximal femoral reference axis and included measurements at the level of the greater trochanter, femoral neck, base of the femoral neck, and level of the lesser trochanter. Intraclass correlation coefficients (ICCs) were calculated, and Bland-Altman analysis was performed. Results Forty-five patients (mean age ± standard deviation, 19 years ± 5; 27 female) and 57 hips were evaluated. Inter- and intrarater reliability were excellent for each of the four CT- and MRI-based measurement methods (ICC range, 0.97-0.99). Mean difference between CT- and MRI-based measurement ranged from 0.3° ± 3.4 (P = .58) to 2.1° ± 4.1 (P < .001). Differences between CT and MRI were within the corresponding ICC variation for all four measurement methods. Mean torsion angles were greater by 17.6° for CT and 18.7° for MRI (all P < .001) between the most proximal to the most distal measurement methods. Conclusion MRI- and CT-based femoral torsion measurements showed high agreement and comparable reliability and reproducibility but were dependent on the level of selected landmarks used to define the proximal reference axis. © RSNA, 2020 Online supplemental material is available for this article. See also the editorial by Zoga in this issue.

journal_name

Radiology

journal_title

Radiology

authors

Schmaranzer F,Kallini JR,Miller PE,Kim YJ,Bixby SD,Novais EN

doi

10.1148/radiol.2020192723

subject

Has Abstract

pub_date

2020-08-01 00:00:00

pages

381-390

issue

2

eissn

0033-8419

issn

1527-1315

journal_volume

296

pub_type

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