Metacarpophalangeal Joints in Rheumatoid Arthritis: Delayed Gadolinium-Enhanced MR Imaging of Cartilage--A Feasibility Study

Radiology. 2010 Nov;257(2):441-7. doi: 10.1148/radiol.10100459. Epub 2010 Aug 31.

Abstract

Purpose: To evaluate the feasibility of delayed gadolinium-enhanced magnetic resonance (MR) imaging of the cartilage of metacarpophalangeal (MCP) joints in patients with rheumatoid arthritis (RA) compared with that in control subjects.

Materials and methods: Institutional review board approval and informed consent were obtained. Thirty-one MCP joints in 10 patients with RA (mean age, 59 years; range, 35-77 years) and six healthy volunteers (mean age, 51 years; range, 30-71 years) were examined with delayed gadolinium-enhanced MR imaging of cartilage. Sagittal images of the second and third MCP joints (hereafter, MCP II and MCP III) were acquired with a three-dimensional dual-flip-angle gradient-echo sequence at 3.0 T. B(1) field inhomogeneity-corrected T1 maps were calculated, and delayed gadolinium-enhanced MR imaging of cartilage values for phalangeal and metacarpal cartilage were determined. In addition, cartilage thickness was measured. A nonparametric Mann-Whitney U test was used to assess differences between groups.

Results: Phalangeal and metacarpal delayed gadolinium-enhanced MR imaging of cartilage values in patients with RA (MCP II: 388 msec ± 105 [standard deviation] and 342 msec ± 79, respectively; MCP III: 409 msec ± 96 and 371 msec ± 89, respectively) were significantly lower than in control subjects (MCP II: 598 msec ± 62 and 560 msec ± 51, respectively; MCP III: 586 msec ± 57 and 561 msec ± 80, respectively). Cartilage thickness of both joints was comparable in patients with RA (MCP II: 1.28 mm ± 0.50, MCP III: 1.17 mm ± 0.24) and control subjects (MCP II: 1.42 mm ± 0.33, MCP III: 1.18 mm ± 0.26).

Conclusion: Delayed gadolinium-enhanced MR imaging of cartilage of the MCP joints is feasible at 3.0 T. Delayed gadolinium-enhanced MR imaging of cartilage may help to assess cartilage degeneration in morphologically normal-appearing MCP II and III cartilage in patients with RA.

MeSH terms

  • Adult
  • Aged
  • Arthritis, Rheumatoid / pathology*
  • Cartilage, Articular / pathology*
  • Case-Control Studies
  • Contrast Media*
  • Feasibility Studies
  • Female
  • Gadolinium DTPA*
  • Humans
  • Image Interpretation, Computer-Assisted
  • Imaging, Three-Dimensional
  • Magnetic Resonance Imaging / methods*
  • Male
  • Metacarpophalangeal Joint / pathology*
  • Middle Aged
  • Statistics, Nonparametric

Substances

  • Contrast Media
  • Gadolinium DTPA