ArticleJournal of the Pediatric Orthopaedic Society of North America2024
Perfusion magnetic resonance imaging correlates with the duration of stages and lateral pillar class in Legg-Calvé-Perthes disease.
Article in Journal of the Pediatric Orthopaedic Society of North America, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 2 papers.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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2 citing papers in PubMed.
- Treatment for primary avascular necrosis of the lower limb in childhood.The Cochrane database of systematic reviews · 2026Article
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Corrections and comments
- Erratum issued
Authors and funding
9 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Background: Legg-Calvé-Perthes disease (LCPD) progresses through 4 stages characterized by unique radiographic features, and stage duration is recognized as an important prognostic factor. Newer perfusion magnetic resonance imaging (pMRI) allows for the evaluation of vascularity early in the disease process. This study aims to describe the relationship between global and regional perfusion patterns on early pMRI and the duration of Waldenström stages. A secondary aim was to verify the relationship between hypoperfusion and subsequent lateral pillar class. Methods: Through a prospectively collected multicenter international cohort, patients with early LCPD (Waldenström Stage I) and pMRI were followed with serial radiographs at 3-month intervals for a minimum of 2 years. Epiphyseal hypoperfusion was quantified by HipVasc Software for the entire epiphysis and regional thirds of the femoral head. Waldenström stages and lateral pillar class were determined by mode assessments from 3 pediatric orthopedic surgeons. Duration of the stage was defined as the interval between the first radiograph demonstrating features of stage IIa and stage IIIa for fragmentation and between IIIa and IV for reossification. Results: One-hundred and seven patients (88.8% male, median age 8.0 years) met the study criteria. The average global hypoperfusion was 73.7%. Poorer global perfusion was predictive of a longer duration of fragmentation (rho = 0.34, Conclusions: The degree of both global and regional hypoperfusion correlated with the duration of fragmentation and reossification stages in LCPD. Lateral epiphyseal hypoperfusion is predictive of lateral pillar class. Taken together, the information provided by perfusion magnetic resonance imaging can provide crucial prognostic information for children with LCPD. Key Concepts: 1.Amount of hypoperfusion both globally and regionally on perfusion MRI correlates with the duration of fragmentation and reossification stages in LCPD.2.Lateral epiphyseal hypoperfusion correlates with lateral pillar class.3.Perfusion information offered by contrast MRI can offer crucial prognostic information in children with LCP. Level of Evidence: II Prognostic Study.
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