Delayed gadolinium-enhanced MRI of cartilage (dGEMRIC) in early knee osteoarthritis

Magn Reson Med. 2003 Mar;49(3):488-92. doi: 10.1002/mrm.10389.

Abstract

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.

Publication types

  • Comparative Study
  • Evaluation Study

MeSH terms

  • Adult
  • Aged
  • Arthroscopy
  • Cartilage, Articular / diagnostic imaging
  • Cartilage, Articular / metabolism
  • Cartilage, Articular / pathology*
  • Contrast Media*
  • Female
  • Gadolinium DTPA*
  • Glycosaminoglycans / metabolism
  • Humans
  • Image Enhancement / methods
  • Magnetic Resonance Imaging / methods*
  • Male
  • Middle Aged
  • Osteoarthritis, Knee / diagnosis*
  • Osteoarthritis, Knee / diagnostic imaging
  • Osteoarthritis, Knee / pathology
  • Radiography
  • Sensitivity and Specificity
  • Time Factors

Substances

  • Contrast Media
  • Glycosaminoglycans
  • Gadolinium DTPA