Int J Comput Assist Radiol Surg - Preliminary evaluation of an MRI-based technique for displaying and quantifying bony deformities in cam-type femoroacetabular impingement.

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Resumo

RPOSE: Characterizing aspheric deformities of the femoral head-neck junction in cam-type femoroacetabular impingement (FAI) requires representing the location, size, or extent of the bony lesion. The objectives of this work are to (1) assess the feasibility of creating 3D models of cam deformities from MRI sets, (2) present a standardized 2D visualization of the lesion, and (3) present and evaluate the potential utility of summary metrics in distinguishing between FAI patients and control subjects.METHODS: Using MRIs from five subjects with diagnosed cam-type FAI and four healthy subjects, we developed a technique based on subtracting an estimated normal surface from each subject's actual bone surface in order to generate a subject-specific 2D "diagnosis graph" that characterized the femoral deformity. The models from three control subjects were combined to create the baseline model.RESULTS: The RMS fitting error between the surface models of individual control subjects and their corresponding baseline models was 1.05 mm across the head and the head-to-neck transition region. In the anterosuperior region of the 2D diagnosis graphs, the mean height of the detected cam deformities relative to the estimated baseline normal shape was 17.9 % of the head radius for the five FAI subjects (95 % CI 8.5-27.3 %) and 7.0 % (95 % CI 2.9-11.1 %) for the four control subjects. A binary logistic regression analysis indicated that an h/r ratio larger than a threshold of [Formula: see text] = 10.7 % (equivalent to approximately 2.3 mm in height) yielded the best discrimination between cam-type FAI subjects and normal subjects.CONCLUSIONS: Our 2D diagnosis graph qualitatively enabled the cam-type lesions in four of our five diagnosed patients to be clearly visualized on MRI-derived models. We believe this visualization tool may be helpful in better characterizing cam-type lesions for diagnosis and for developing more precise plans for surgical treatment.

Resumo Limpo

rpose character aspher deform femor headneck junction camtyp femoroacetabular imping fai requir repres locat size extent boni lesion object work assess feasibl creat d model cam deform mri set present standard d visual lesion present evalu potenti util summari metric distinguish fai patient control subjectsmethod use mris five subject diagnos camtyp fai four healthi subject develop techniqu base subtract estim normal surfac subject actual bone surfac order generat subjectspecif d diagnosi graph character femor deform model three control subject combin creat baselin modelresult rms fit error surfac model individu control subject correspond baselin model mm across head headtoneck transit region anterosuperior region d diagnosi graph mean height detect cam deform relat estim baselin normal shape head radius five fai subject ci ci four control subject binari logist regress analysi indic hr ratio larger threshold formula see text equival approxim mm height yield best discrimin camtyp fai subject normal subjectsconclus d diagnosi graph qualit enabl camtyp lesion four five diagnos patient clear visual mrideriv model believ visual tool may help better character camtyp lesion diagnosi develop precis plan surgic treatment

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