Morrison William B
Department of Radiology, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania 19107, USA.
Semin Musculoskelet Radiol. 2005 Jun;9(2):125-34. doi: 10.1055/s-2005-872338.
Indirect MR arthrography involves intravenous injection of a standard dose of Gadolinium contrast followed, in delayed fashion, by MR imaging. Contrast in taken up by the joint at a rate dependent on a variety of factors including synovial area, vascularity, permeability, and pre-existing joint effusion. Patient acceptance is higher than with direct intra-articular injection, and logical considerations (e.g., not needing a radiologist present) make this an attractive alternative to direct MR arthrography. At best, an indirect MR arthrography exam can look virtually identical to a direct MR arthrogram. However, the radiologist should be aware that vascular tissue inside and outside the joint will enhance, which may be considered either an advantage or disadvantage. Additionally, since all compartments of the joint enhance, information regarding abnormal communication of contrast material is absent. Suboptimal exams occur due to the need for diffusion of contrast into the joint. Exercise can help improve the quality of exams. Using an adequate time delay is essential for optimizing indirect MR arthrography.
间接磁共振关节造影术包括静脉注射标准剂量的钆对比剂，随后延迟进行磁共振成像。对比剂被关节摄取的速率取决于多种因素，包括滑膜面积、血管分布、通透性以及既往存在的关节积液。患者对其接受度高于直接关节内注射，并且从逻辑角度考虑（例如，无需放射科医生在场），这使其成为直接磁共振关节造影术的一个有吸引力的替代方法。在最佳情况下，间接磁共振关节造影检查的图像几乎与直接磁共振关节造影的图像相同。然而，放射科医生应意识到关节内外的血管组织会增强，这可能被视为优点或缺点。此外，由于关节所有腔室都会增强，因此缺乏关于对比剂异常相通的信息。由于需要对比剂扩散到关节内，会出现检查效果欠佳的情况。运动有助于提高检查质量。使用足够的时间延迟对于优化间接磁共振关节造影术至关重要。
