Document Detail


Rheumatoid arthritis of the knee: value of gadopentetate dimeglumine-enhanced MR imaging.
MedLine Citation:
PMID:  1898545     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
In an attempt to differentiate among joint effusion, synovitis, pannus, and subchondral sclerosis in patients with clinically proved chronic rheumatoid arthritis, we used gadopentetate dimeglumine-enhanced MR imaging to examine 23 patients with acute knee symptoms. All patients had had rheumatoid arthritis for more than 6 months and satisfied four or more of the criteria of the American Rheumatism Association for rheumatoid arthritis. MR imaging was performed on a 1.5-T machine by using unenhanced T1-weighted spin-echo imaging, unenhanced T2*-weighted gradient-echo imaging, and unenhanced and enhanced T1-weighted gradient-echo imaging. Signal intensities of the synovium and bone marrow were measured with the region-of-interest technique on unenhanced and enhanced T1-weighted gradient-echo scans. Conventional radiographs were available for each patient. Joint effusion, synovitis, intraarticular pannus, subchondral sclerosis, and subchondral pannus had the same signal intensities on unenhanced T1-weighted spin-echo, unenhanced T1-weighted gradient-echo, and unenhanced T2*-weighted gradient-echo MR images, and could not be differentiated from one another. On enhanced T1-weighted gradient-echo sequences, pannus and synovitis showed marked enhancement in 15 patients, whereas joint effusion and sclerosis did not. Synovitis was diagnosed if the synovial membrane showed high enhancement; pannus was diagnosed if enhancing masses were seen within the joint space or in the subchondral area. In eight of the 23 joints, there was no enhancement of the synovium or intraarticular or subchondral tissue. We conclude that gadopentetate dimeglumine-enhanced MR imaging allows differentiation between synovitis and joint effusion and between subchondral pannus and subchondral sclerosis. Enhancement of the synovium and pannus indicates acute inflammation of the joint.
Authors:
G Adam; M Dammer; K Bohndorf; R Christoph; F Fenke; R W Günther
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  AJR. American journal of roentgenology     Volume:  156     ISSN:  0361-803X     ISO Abbreviation:  AJR Am J Roentgenol     Publication Date:  1991 Jan 
Date Detail:
Created Date:  1991-01-23     Completed Date:  1991-01-23     Revised Date:  2008-02-15    
Medline Journal Info:
Nlm Unique ID:  7708173     Medline TA:  AJR Am J Roentgenol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  125-9     Citation Subset:  AIM; IM    
Affiliation:
Department of Diagnostic Radiology, Aachen University of Technology, Germany.
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Aged
Arthritis, Rheumatoid / complications,  diagnosis*
Bone Cysts
Cartilage, Articular
Female
Humans
Image Enhancement / methods*
Knee Joint / pathology*
Ligaments, Articular
Magnetic Resonance Imaging / methods*
Male
Menisci, Tibial
Middle Aged
Pentetic Acid / diagnostic use*
Synovial Membrane
Chemical
Reg. No./Substance:
67-43-6/Pentetic Acid

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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