MRI of the knee in rheumatoid arthritis: Gd-DTPA perfusion dynamics

J Comput Assist Tomogr. 1993 Sep-Oct;17(5):781-5. doi: 10.1097/00004728-199309000-00022.

Abstract

Objective: Seventeen knees in 13 patients with rheumatoid arthritis (RA) were studied with MRI to clarify the dynamics of Gd-DTPA administered intravenously and to determine an optimal imaging time.

Materials and methods: Dynamic gradient recalled echo imaging with bolus intravenous injection of Gd-DTPA was performed following unenhanced T1- and T2-weighted SE imaging. Late-phase SE or serial gradient recalled echo images were obtained following dynamic study.

Results: There was rapid enhancement of synovium with maximal enhancement ratio of 96-499% (mean 214 +/- 111%) with Tmax ranging from 120 to 660 s (mean 253 s). The synovial enhancement persisted over 80% of the peak enhancement for 6-27 min (average 12 min) with eventual enhancement of joint effusion from the periphery to the center beginning at 6 min to 8 min, 20 s after contrast medium injection. Complete enhancement of joint effusion was noted in four joints at 24-86 min.

Conclusion: We conclude that enhancement of synovium in patients with RA is a time-dependent phenomenon, and an optimal imaging time would be within 5 min following contrast medium administration.

MeSH terms

  • Adult
  • Aged
  • Arthritis, Rheumatoid / diagnosis*
  • Arthritis, Rheumatoid / pathology
  • Contrast Media
  • Female
  • Gadolinium DTPA
  • Humans
  • Knee Joint / pathology*
  • Magnetic Resonance Imaging*
  • Middle Aged
  • Organometallic Compounds*
  • Pentetic Acid*
  • Synovial Membrane / pathology

Substances

  • Contrast Media
  • Organometallic Compounds
  • Pentetic Acid
  • Gadolinium DTPA