title: Delayed gadolinium-enhanced magnetic resonance imaging (dGEMRIC) of hip joint cartilage: better cartilage delineation after intra-articular than intravenous gadolinium injection.
abstract: OBJECTIVE
  To investigate and compare delayed gadolinium (Gd-DTPA)-enhanced magnetic resonance imaging (MRI) of cartilage (dGEMRIC) in the hip joint using intravenous (i.v.) or ultrasound-guided intra-articular (i.a.) Gd-DTPA injection.
  
  
  METHODS
  In 10 patients (50% males, mean age 58 years) with clinical and radiographic hip osteoarthritis (OA; Kellgren score II-III), MRI of the hip was performed twice on a clinical 1.5T MR scanner: On day 1, before and 90-180 min after 0.3 mmol/kg body weight i.v. Gd-DTPA and, on day 8, 90-180 min after ultrasound-guided i.a. injection of a 4 mmol/l Gd-DTPA solution. Coronal STIR, coronal T1 fat-saturated spin-echo, and a cartilage-sensitive gradient-echo sequence (3D T1 SPGR) in the sagittal plane were applied. RESULTS Both the post-i.v. and post-i.a. Gd-DTPA images showed significantly higher signal-to-noise (SNR) and contrast-to-noise (CNR) in the joint cartilage compared to the non-enhanced images (P < 0.002). I.a. Gd-DTPA provided significantly higher SNR and CNR compared to i.v. Gd-DTPA (P < 0.01). Furthermore, a better delineation of the cartilage in the synovial/cartilage zone and of the chondral/subchondral border was observed.
  
  
  CONCLUSIONS
  The dGEMRIC MRI method markedly improved delineation of hip joint cartilage compared to non-enhanced MRI. The i.a. Gd-DTPA provided the best cartilage delineation. dGEMRIC is a clinically applicable MRI method that may improve identification of early subtle cartilage damage and the accuracy of volume measurements of hip joint cartilage.
authors.affiliation: Parker Institute, Frederiksberg Hospital, Frederiksberg, Copenhagen, Denmark. parker@fh.hosp.dk
authors.forename: M
authors.initials: M
authors.lastname: Boesen
authors.forename: K E
authors.initials: KE
authors.lastname: Jensen
authors.forename: E
authors.initials: E
authors.lastname: Qvistgaard
authors.forename: B
authors.initials: B
authors.lastname: Danneskiold-Samsøe
authors.forename: C
authors.initials: C
authors.lastname: Thomsen
authors.forename: M
authors.initials: M
authors.lastname: Ostergaard
authors.forename: H
authors.initials: H
authors.lastname: Bliddal
mesh_terms: D000328:Adult; D000368:Aged; D002358:Cartilage, Articular / Q000473:pathology*; D003287:Contrast Media / Q000008:administration & dosage*; D005260:Female; D019786:Gadolinium DTPA; D006621:Hip Joint / Q000473:pathology*; D006801:Humans; D007089:Image Enhancement / Q000379:methods; D007270:Injections, Intra-Articular / Q000379:methods; D007275:Injections, Intravenous / Q000379:methods; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D015588:Observer Variation; D015207:Osteoarthritis, Hip / Q000175:diagnosis*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D013997:Time Factors
chemical_list: D003287:Contrast Media; D019786:Gadolinium DTPA