The principal objective of the study is to compare between CT and MRI diagnostic performance (sensibility and specificity) in the preoperative assessment of neurogenic para-osteo-arthritis. The second objectives of the study are: * besides the diagnostic performance (sensibility and specificity), to evaluate the imaging par MRI in visual and descriptive manner heterotopic ossification and connection with vascular and nervous structures. * to study the concordance (two by two) of results of preoperative obtained by MRI and by CT and operative reports. * to study the characteristics of patients with discordant findings (two by two) by MRI, CT scan and operative report.
This is a study on diagnostic performance, non randomized, versus Gold standard (a prospective multicentric cohort). All eligible patients will be proposed consecutively to participate to the study, to undergo preoperative CT scan and MRI examination as usual procedure. The only additional action in this study will be a neurography sequence of type fluorescence subtraction imaging (FSI) during MRI, permitting to obtain more details in visualization of nerve structure and their relations of the ossifications. The enrollment visit will performed by neuro-orthopaedic surgeon during preoperative consultation. The follow-up visit will be an usual post-operative visit, non-specific for the study. The duration for each participant will compound 1 month (the duration between preoperative imaging and surgical resection) added by up to two months of post-operative follow-up.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
OTHER
Masking
NONE
Enrollment
23
CT scan with biphasic injection of contrast product
MRI with injection of contrast
Service d'Imagerie médicale, Hôpital Raymond Poincaré
Garches, Hauts-de-Seine, France
Analysis and comparison of accurate topography of heterotopic ossification on the CT and the MRI
Comparison of preoperative diagnostic performances of CT scan and MRI, based on analysis of topography of heterotopic ossification. On each CT and MRI exam, analysis of accurate topography of heterotopic ossifications relative to the bones, the number of fragments, their relationships with the articular capsule, their mineralization, and the mineralization of the underlying bone.
Time frame: through study completion, an average of 2 year
Analysis and comparison of reporting arterial and venous anatomy
Comparison of preoperative diagnostic performances of CT scan and MRI, based on analysis of reporting arterial and venous anatomy. On each CT and MRI exam, analysis of vascular (arterial and veinous) relations with the heterotopic ossifications, in the case of contact specify the existence of a gutter or a tunnel, and the vessels permeability or occlusion.
Time frame: through study completion, an average of 2 year
Analysis and comparison of reporting nervous structures
Comparison of preoperative diagnostic performances of CT scan and MRI, based on analysis of reporting nervous structures. On each CT and MRI exam, analysis of nervous structures relations with the heterotopic ossifications, in the case of contact specify the existence of a gutter or a tunnel, and the the existence of suffering nerve or denervation signs.
Time frame: through study completion, an average of 2 year
Performances of MRI for diagnosis of arterial-venous
Performances of MRI for diagnosis of arterial-venous relation (gutter, stenosis, thrombosis or vascular occlusion, collateral circulation...)
Time frame: through study completion, an average of 2 year
Performances of MRI for diagnosis of nervous structures (nerve's location, nerve signal anomalies, signs of suffering and denervation...)
Time frame: through study completion, an average of 2 year
Rate of incidence of adverse event during surgical operation
The rate of incidence of adverse event during surgical procedure will be calculated.
Time frame: through study completion, an average of 2 year
Concordance correlation coefficient
Concordance correlation coefficient two by two (Gwet concordance coefficient for binary qualitative variables; and W of Kendal concordance coefficient for ordinal qualitative variables or quantitative variables) between results of preoperative MRI and CT and operative report describing arterial-venous relation, and nervous structures.
Time frame: through study completion, an average of 2 year
Characteristic of patients with discordant results
Identify all discordances between CT or MRI and the surgery findings, about topography of heterotopic ossification, vascular relations and nervous structures relations. Analysis of characteristics of patients with discordant results between preoperative MRI resluts or preoperative CT results relative to the operative report.
Time frame: through study completion, an average of 2 year
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