Intravenous administration of gadolinium in the evaluation of rheumatoid arthritis of the shoulder.
The authors sought to determine the utility of intravenously administered gadolinium chelates in magnetic resonance imaging (MRI) of patients with rheumatoid arthritis of the shoulder. One shoulder was examined for each of 12 patients--6 men and 6 women, ranging in age from 48 to 71 (average 63) years--with well-established disease. The patients had had the disease for 1 to 25 (average 13) years. Static MRI was performed before and after infusion of gadolinium diethylenetriaminepentaacetic acid (Gd-DTPA) (0.1 mmol/kg body weight); T1-weighted or proton-density images (repetition time [TR] 600 to 1000 ms, echo time [TE] 15 to 30 ms) were obtained. Images obtained after enhancement were particularly useful in the differentiation of pannus from fluid and also allowed improved delineation of tears of the supraspinatus tendon. In addition, contrast-enhanced dynamic gradient-echo spoiled GRASS sequences (TR 50 ms, TE 11 ms, flip angle 70 degrees) were obtained for all patients; for these sequences the same slice was imaged repeatedly at 20-second intervals. The rate of increase of signal intensity in abnormal synovium varied from 0.64 to 5.83 (average 2.30, standard deviation [SD] 1.67) units/second; the enhancement factor ranged from 1.55 to 4.64 (average 2.63, SD 0.98). The authors conclude that for imaging the shoulder enhancement with Gd-DTPA allows improved distinction between synovial thickening and joint effusion and may improve assessment of the rotator cuff. The wide range in the rate of signal increase and total enhancement during dynamic imaging probably reflected heterogeneity in the study population.
Munk
P L
PL
Department of Diagnostic Radiology and Nuclear Medicine, University Hospital, University of Western Ontario, London.
Vellet
A D
AD
Levin
M F
MF
Bell
D A
DA
Harth
M M
MM
McCain
G A
GA
D000173:Acromioclavicular Joint; D000368:Aged; D001172:Arthritis, Rheumatoid / Q000175:diagnosis*; D002968:Clavicle / Q000473:pathology; D005260:Female; D005682:Gadolinium / Q000008:administration & dosage*; D019786:Gadolinium DTPA; D006801:Humans; D007089:Image Enhancement / Q000379:methods*; D007275:Injections, Intravenous; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009942:Organometallic Compounds / Q000008:administration & dosage*; D004369:Pentetic Acid / Q000008:administration & dosage*; D012785:Shoulder Joint; D013583:Synovial Membrane / Q000473:pathology; D013708:Tendon Injuries / Q000175:diagnosis
D009942:Organometallic Compounds; D004369:Pentetic Acid; D005682:Gadolinium; D019786:Gadolinium DTPA