Abstract
Introduction
Non-union perfusion can be visualized with dynamic contrast-enhanced (DCE) MRI. This
study evaluated DCE-MRI to predict non-union consolidation after surgery and detect
factors that affect bone healing.
Materials and methods
Between 2010 and 2015 non-union perfusion was prospectively quantified in 205 patients
(mean age, 51.5 years, 129 men, 76 women) before intervention and at 6, 12, 26, 52
and more weeks follow-up. DCE-MRI results were related to the osseous consolidation,
the ability to predict successful outcome was estimated by ROC analysis. The relevance
of the body mass index (BMI) and the non-union severity score (NUSS) to the healing
process was assessed.
Results
Tibial (n = 99) and femoral (n = 76) non-unions were most common. Consolidation could be assessed in 169 patients,
of these 103 (61%) showed eventual healing and demonstrated higher perfusion than
in failed consolidation at 6 (p = 0.0226), 12 (p = 0.0252) and 26 (p = 0.0088) weeks follow-up. DCE-MRI at 26 weeks follow-up predicted non-union consolidation
with a sensitivity of 75% and a specificity of 87% (false classification rate 19%).
Higher BMI (p = 0.041) and NUSS (p < 0.0001) were associated with treatment failure.
Conclusions
DCE-MRI perfusion analysis after non-union surgery predicts successful outcome and
could facilitate the decision of early intervention. NUSS and BMI are important prognostic
factors concerning consolidation.
Keywords
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Publication history
Published online: January 09, 2017
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