title: Direct comparison of intra-articular versus intravenous delayed gadolinium-enhanced MRI of hip joint cartilage.
abstract: OBJECTIVE
  To investigate the potential of delayed gadolinium-enhanced magnetic resonance imaging in cartilage (dGEMRIC) after intra-articular (ia) contrast agent administration at 3 Tesla (T), a paired study comparing intravenous (iv) dGEMRIC (standard) with ia-dGEMRIC was performed.
  
  
  METHODS
  Thirty-five symptomatic patients with suspected cartilage damage underwent ia- and iv-dGEMRIC. MRI was performed with a 3T system wherein the interval between both measurements was 2 weeks. For iv-dGEMRIC, FDA approved Gd-DOTA(-) was injected intravenously 45 min before the MRI scan. For ia-dGEMRIC, 10-20 mL of a 2 mM solution of Gd- DOTA(-) was injected under fluoroscopic guidance 30 min before the MRI scan.
  
  
  RESULTS
  Both ia- and iv-dGEMRIC demonstrated the typical T1Gd pattern in hip joint cartilage with increasing values toward the superior regions in acetabular cartilage reflecting the higher glycosaminoglycan (GAG) content in the main weight-bearing area. Correlation analysis revealed a moderate correlation between both techniques (r = 0.439, P-value < 0.001), whereas the T1Gd values for iv-dGEMRIC were significantly higher than those for ia-dGEMRIC. This corresponds with the Bland-Altman plot analysis, which revealed a systemic bias (higher T1Gd values after iv gadolinium application) of ∼70 ms.
  
  
  CONCLUSIONS
  Ia-dGEMRIC was able to reveal the characteristic T1Gd pattern in hip joint cartilage confirming the sensitivity of ia-dGEMRIC for GAG. In addition, there was a significant correlation between iv-dGEMRIC and ia-dGEMRIC. However, the T1Gd values after ia contrast media application were significantly lower than those after iv application that has to be considered for future studies.
authors.affiliation: Univ Dusseldorf, Medical Faculty, Department of Orthopedic Surgery, D-40225 Dusseldorf, Germany.
authors.forename: Christoph
authors.initials: C
authors.lastname: Zilkens
authors.forename: Falk
authors.initials: F
authors.lastname: Miese
authors.forename: Young-Jo
authors.initials: YJ
authors.lastname: Kim
authors.forename: Marcus
authors.initials: M
authors.lastname: Jäger
authors.forename: Tallal C
authors.initials: TC
authors.lastname: Mamisch
authors.forename: Harish
authors.initials: H
authors.lastname: Hosalkar
authors.forename: Gerald
authors.initials: G
authors.lastname: Antoch
authors.forename: Rüdiger
authors.initials: R
authors.lastname: Krauspe
authors.forename: Bernd
authors.initials: B
authors.lastname: Bittersohl
mesh_terms: D061605:Administration, Intravenous; D000293:Adolescent; D000328:Adult; D002358:Cartilage, Articular / Q000473:pathology*; D003287:Contrast Media / Q000008:administration & dosage*; D005260:Female; D005682:Gadolinium / Q000008:administration & dosage*; D006621:Hip Joint / Q000473:pathology; D006801:Humans; D007089:Image Enhancement; D007091:Image Processing, Computer-Assisted; D021621:Imaging, Three-Dimensional; D007270:Injections, Intra-Articular; D018810:Magnetic Resonance Angiography; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D010146:Pain; D055815:Young Adult
chemical_list: D003287:Contrast Media; D005682:Gadolinium
keywords: 3T; cartilage; dGEMRIC; hip joint; osteoarthritis