Delayed gadolinium-enhanced MRI of cartilage (dGEMRIC) in early knee osteoarthritis.
Delayed contrast-enhanced MRI of cartilage (dGEMRIC) is a noninvasive technique to study cartilage glycosaminoglycan (GAG) content in vivo. This study evaluates dGEMRIC in patients with preradiographic degenerative cartilage changes. Seventeen knees in 15 patients (age 35-70) with arthroscopically verified cartilage changes (softening and fibrillations) in the medial or lateral femoral compartment, knee pain, and normal weight-bearing radiography were included. MRI (1.5 T) was performed precontrast and at 1.5 and 3 hr after an intravenous injection of Gd-DTPA(2-) at 0.3 mmol/kg body weight. T(1) measurements were made in regions of interest in medial and lateral femoral cartilage using sets of five turbo inversion recovery images. Precontrast, R(1) (R(1) = 1/T(1), 1/s) was slightly lower in diseased compared to reference compartment, indicating increased hydration (P = 0.01). Postcontrast, R(1) was higher in diseased than in reference compartment at 1.5 hr, 3.45 +/- 0.90 and 2.64 +/- 0.58 (mean +/- SD), respectively (P < 0.01), as well as at 3 hr, 2.94 +/- 0.60 and 2.50 +/- 0.37, respectively (P = 0.01). The washout of the contrast medium was faster in diseased cartilage as shown by a higher R(1) at 1.5 than at 3 hr in the diseased but not in the reference compartment. In conclusion, dGEMRIC can identify GAG loss in early stage cartilage disease with a higher sensitivity at 1.5 than 3 hr.
Tiderius
Carl Johan
CJ
Department of Orthopedics, Diagnostic Radiology and Radiation Physics, Malmö University Hospital, Lund University, Sweden.
Olsson
Lars E
LE
Leander
Peter
P
Ekberg
Olle
O
Dahlberg
Leif
L
D000328:Adult; D000368:Aged; D001182:Arthroscopy; D002358:Cartilage, Articular / Q000000981:diagnostic imaging / Q000378:metabolism / Q000473:pathology*; D003287:Contrast Media; D005260:Female; D019786:Gadolinium DTPA; D006025:Glycosaminoglycans / Q000378:metabolism; D006801:Humans; D007089:Image Enhancement / Q000379:methods; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D020370:Osteoarthritis, Knee / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000473:pathology; D011859:Radiography; D012680:Sensitivity and Specificity; D013997:Time Factors
D003287:Contrast Media; D006025:Glycosaminoglycans; D019786:Gadolinium DTPA