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Direct comparison of intra‐articular versus intravenous delayed gadolinium‐enhanced MRI of hip joint cartilage
Author(s) -
Zilkens Christoph,
Miese Falk,
Kim YoungJo,
Jäger Marcus,
Mamisch Tallal C.,
Hosalkar Harish,
Antoch Gerald,
Krauspe Rüdiger,
Bittersohl Bernd
Publication year - 2014
Publication title -
journal of magnetic resonance imaging
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.563
H-Index - 160
eISSN - 1522-2586
pISSN - 1053-1807
DOI - 10.1002/jmri.24096
Subject(s) - gadolinium , medicine , magnetic resonance imaging , nuclear medicine , cartilage , gadolinium dtpa , intravenous contrast , articular cartilage , radiology , osteoarthritis , chemistry , computed tomography , anatomy , pathology , alternative medicine , organic chemistry
Purpose 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. Materials and 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 T1 Gd 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 T1 Gd 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 T1 Gd values after iv gadolinium application) of ∼70 ms. Conclusion Ia ‐dGEMRIC was able to reveal the characteristic T1 Gd 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 T1 Gd values after ia contrast media application were significantly lower than those after iv application that has to be considered for future studies. J. Magn. Reson. Imaging 2014;39:94–102. © 2013 Wiley Periodicals, Inc.