title: Delayed gadolinium-enhanced MRI of the meniscus (dGEMRIM) in patients with knee osteoarthritis: relation with meniscal degeneration on conventional MRI, reproducibility, and correlation with dGEMRIC.
abstract: OBJECTIVE
  To assess (1) whether normal and degenerated menisci exhibit different T1GD on delayed gadolinium-enhanced MRI of the meniscus (dGEMRIM), (2) the reproducibility of dGEMRIM and (3) the correlation between meniscus and cartilage T1GD in knee osteoarthritis (OA) patients.
  
  
  METHODS
  In 17 OA patients who underwent dGEMRIM twice within 7 days, meniscus and cartilage T1GD was calculated. Meniscus pathology was evaluated on conventional MRI. T1GD in normal and degenerated menisci were compared using a Student's t-test. Reproducibility was assessed using ICCs. Pearson's correlation was calculated between meniscus and cartilage T1GD.
  
  
  RESULTS
  A trend towards lower T1GD in degenerated menisci (mean: 402 ms; 95% CI: 359-444 ms) compared to normal menisci (mean: 448 ms; 95% CI: 423-473 ms) was observed (p = 0.05). Meniscus T1GD ICCs were 0.85-0.90. The correlation between meniscus and cartilage T1GD was moderate in the lateral (r = 0.52-0.75) and strong in the medial compartment (r = 0.78-0.94).
  
  
  CONCLUSIONS
  Our results show that degenerated menisci have a clear trend towards lower T1GD compared to normal menisci. Since these results are highly reproducible, meniscus degeneration may be assessed within one delayed gadolinium-enhanced MRI simultaneously with cartilage. The strong correlation between meniscus and cartilage T1GD suggests concomitant degeneration in both tissues in OA, but also suggests that dGEMRIC may not be regarded entirely as sulphated glycosaminoglycan specific.
  
  
  CONCLUSIONS
  dGEMRIM T1 GD can possibly be used to assess meniscal degeneration; dGEMRIM yields highly reproducible meniscal T1 GD in early stage osteoarthritic patients; Concomitant degeneration of cartilage and meniscus tissue occurs in early stage osteoarthritis; dGEMRIC cannot be regarded as entirely sulphated glycosaminoglycan specific.
authors.affiliation: Department of Orthopaedic Surgery, Erasmus MC, University Medical Center, Rotterdam, The Netherlands, j.vantiel@erasmusmc.nl.
authors.forename: Jasper
authors.initials: J
authors.lastname: van Tiel
authors.forename: Gyula
authors.initials: G
authors.lastname: Kotek
authors.forename: Max
authors.initials: M
authors.lastname: Reijman
authors.forename: Pieter K
authors.initials: PK
authors.lastname: Bos
authors.forename: Esther E
authors.initials: EE
authors.lastname: Bron
authors.forename: Stefan
authors.initials: S
authors.lastname: Klein
authors.forename: Jan A N
authors.initials: JA
authors.lastname: Verhaar
authors.forename: Gabriel P
authors.initials: GP
authors.lastname: Krestin
authors.forename: Harrie
authors.initials: H
authors.lastname: Weinans
authors.forename: Edwin H G
authors.initials: EH
authors.lastname: Oei
mesh_terms: D003287:Contrast Media; D005260:Female; D005500:Follow-Up Studies; D019786:Gadolinium DTPA; D006801:Humans; D007089:Image Enhancement / Q000379:methods*; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008592:Menisci, Tibial / Q000473:pathology*; D008875:Middle Aged; D020370:Osteoarthritis, Knee / Q000175:diagnosis*; D011446:Prospective Studies; D015203:Reproducibility of Results
chemical_list: D003287:Contrast Media; D019786:Gadolinium DTPA