Juvenile rheumatoid arthritis of the knee: MR evaluation with Gd-DOTA.
Synovial hypertrophy, effusion, and articular cartilage status were evaluated with gadolinium tetraazacyclododecanetetraacetic acid (DOTA)-enhanced magnetic resonance (MR) imaging in 24 knees in 24 pediatric patients (17 female, seven male; mean age, 10 years; range, 3-18 years) with juvenile rheumatoid arthritis (JRA). T1-weighted spin-echo sequences were performed with a 0.5-T unit before and immediately after injection of Gd-DOTA (0.1 mmol/kg). Substantial enhancement of synovial proliferation was seen in 23 of 24 knees, allowing precise assessment of pannus extension (n = 23), joint effusion (n = 21), cartilage loss (n = 21), and meniscal hypotrophy (n = 23). On T1-weighted images without contrast enhancement, cartilage thickness, loculation of joint effusion, and pannus extension were underestimated. Thus, Gd-DOTA-enhanced MR imaging is mandatory in the assessment of knee involvement in children with JRA and may prove to be useful in the evaluation of response to therapy.
Hervé-Somma
C M
CM
Department of Pediatric Radiology, Hopital des Enfants Malades, Paris, France.
Sebag
G H
GH
Prieur
A M
AM
Bonnerot
V
V
Lallemand
D P
DP
D001171:Arthritis, Juvenile / Q000175:diagnosis* / Q000453:epidemiology; D002648:Child; D003287:Contrast Media; D005069:Evaluation Studies as Topic; D005260:Female; D006571:Heterocyclic Compounds; D006801:Humans; D007717:Knee / Q000473:pathology*; D007719:Knee Joint / Q000473:pathology*; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D009942:Organometallic Compounds; D011446:Prospective Studies
D003287:Contrast Media; D006571:Heterocyclic Compounds; D009942:Organometallic Compounds; C050823:gadolinium 1,4,7,10-tetraazacyclododecane-N,N',N'',N'''-tetraacetate