BOLD-MRI early detect femoral head osteonecrosis following steroid-treated patients

The purpose of the study is to evaluate the feasibility of blood oxygenation level-dependent MRI (BOLD-MRI) to early detect the femoral head osteonecrosis (FHON). One hundred twelve patients were recruited who had received steroid treatment. The normal control group included 10 volunteers with 20 hips. MRI examinations were performed in all patients following up at 1, 4 to 5, 7 to 8, and 12 to 13 months after steroid therapy. With the section cross as the biggest lesion in coronal images, we set 6 regions of interest (ROIs) per section to analyze the morphological performance of routine MRI sequences and the differences of R2* values and their dynamic changes of BOLD-MRI between the control and the FHON group. A total of 15 hip joints were diagnosed with FHON. Seven right hips and 8 left hips were affected. In the first and second MRI examinations, the area of the lesion for both conventional MRI and BOLD-MRI R2* mapping was difficult to distinguish the lesion border. However, at the third and the fourth MRI examinations, some of the affected regions for R2* mapping were larger than those in conventional sequences for the same patient. BOLD-MRI has some significant advantages in early detecting FHON over conventional MRI techniques and it can be feasible noninvasive tool for detecting and evaluating FHON after steroid therapy.