Indirect MR arthrography: optimization and clinical applications.
OBJECTIVE
To evaluate and optimize a method for producing magnetic resonance (MR) images similar to MR arthrograms of multiple synovial joints with intravenous gadopentetate dimeglumine injection.


METHODS
The authors examined the effects of joint motion, dose of gadopentetate dimeglumine (0.1, 0.2, and 0.4 mmol/kg), and fat saturation on the enhancement rate of the joint cavity and the degree of image contrast generated among articular structures on MR images in 14 healthy volunteers. Shoulder, elbow, wrist, hip, knee, and ankle joints of 10 volunteers were imaged with optimized parameters. Indirect MR arthrographic findings in 17 patients with joint disorders (eg, rotator-cuff tears, meniscal tears, and osteoarthritis) were compared with arthroscopic findings.


RESULTS
Fat-saturated images obtained after 10 minutes of exercise and administration of 0.1 mmol/kg gadopentetate dimeglumine were similar to those obtained after intraarticular injection of contrast medium. Exercising the joint yielded the strongest joint-cavity enhancement. Increasing the dose of contrast medium in the unexercised joint did not statistically significantly improve the contrast-to-noise ratio. Rotator cuff tears, meniscal tears, and cartilage defects were better delineated with this method than with unenhanced MR imaging and showed good correlation with arthroscopic results.


CONCLUSIONS
Indirect MR arthrography of an exercised joint provides homogeneous enhancement and improved delineation of soft-tissue structures.
Vahlensieck
M
M
Department of Radiology, University of Bonn, Germany.
Peterfy
C G
CG
Wischer
T
T
Sommer
T
T
Lang
P
P
Schlippert
U
U
Genant
H K
HK
Schild
H H
HH
D000328:Adult; D001182:Arthroscopy; D003287:Contrast Media / Q000008:administration & dosage; D005260:Female; D005682:Gadolinium / Q000008:administration & dosage; D019786:Gadolinium DTPA; D006801:Humans; D007275:Injections, Intravenous; D007592:Joint Diseases / Q000175:diagnosis; D007596:Joints / Q000033:anatomy & histology* / Q000473:pathology; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009942:Organometallic Compounds / Q000008:administration & dosage; D010003:Osteoarthritis / Q000175:diagnosis; D004369:Pentetic Acid / Q000008:administration & dosage / Q000031:analogs & derivatives; D005082:Physical Exertion; D017006:Rotator Cuff / Q000473:pathology; D000070636:Rotator Cuff Injuries; D000070600:Tibial Meniscus Injuries; D014947:Wounds and Injuries / Q000175:diagnosis
D003287:Contrast Media; D009942:Organometallic Compounds; D004369:Pentetic Acid; D005682:Gadolinium; D019786:Gadolinium DTPA