Kwack Kyu-Sung, Cho Jae Hyun, Kim M Myung Soon, Yoon Choon-Sik, Yoon Yeo Seung, Choi Jae Won, Kwon Jong Won, Min Byoung-Hyun, Sun Joo Sung, Kim Sun Yong
Department of Radiology, Ajou University Medical Center, Suwon, South Korea.
Acta Radiol. 2008 Feb;49(1):65-74. doi: 10.1080/02841850701552934.
Magnetic resonance (MR) imaging and measurement of glycosaminoglycan (GAG) have potential for characterization of hyaline articular cartilage. Recently, some reports have demonstrated the potential of direct administration of contrast media for MR imaging of cartilage.
To prove the feasibility of intraarticular gadolinium-enhanced MR imaging of cartilage (iGEMRIC) and T1 relaxation mapping of the articular cartilage in vivo with intraarticular injection of Gd-DTPA2-.
Five healthy beagle dogs underwent MR imaging and T1 relaxation mapping of the knee joints of both hind legs. The delayed gadolinium-enhanced MR imaging of cartilage (dGEMRIC) and iGEMRIC techniques were interchanged with MR imaging. For dGEMRIC, a double routine dose of Gd-DTPA2- (0.2 mM/kg) was administered intravenously. For iGEMRIC, 2.5 and 1.25 mmol/l saline-diluted Gd-DTPA2- solutions were separately injected into the right and left knee joints, respectively, prior to MR imaging. Color-coded T1 maps of 20 femoral condyles were obtained from the dGEMRIC and iGEMRIC images. The signal-to-noise ratio (SNR), contrast-to-noise ratio (CNR), and glycosaminoglycan (GAG) delineation of articular cartilage were compared between the dGEMRIC and iGEMRIC techniques.
The mean SNR was higher with dGEMRIC than with iGEMRIC, but the difference was not statistically significant (P=0.174). The mean (+/-SD) CNR was higher with iGEMRIC (-11.6+/-3.4) than with dGEMRIC (-16.7+/-4.0; P=0.000), although the absolute value of the CNR was higher with dGEMRIC. The layering and gradient distribution of GAG were more clearly visualized on the iGEMRIC images. The mean scores of GAG delineation with dGEMRIC and iGEMRIC were 0.7+/-0.6 and 2.2+/-1.7, respectively. The iGEMRIC method better visualized GAG distribution (P=0.001).
Although the SNR did not differ significantly between the iGEMRIC and dGEMRIC techniques, the color-coded T1 map produced with iGEMRIC allowed better cartilage evaluation. Thus, iGEMRIC exhibits the useful features of both MR arthrography and dGEMRIC, and provides a color-coded T1 map that is useful for diagnosing early articular cartilage damage.
磁共振(MR)成像及糖胺聚糖(GAG)测量在透明关节软骨特征描述方面具有潜力。最近,一些报告已证明直接注射造影剂用于软骨MR成像的潜力。
通过关节内注射钆喷酸葡胺(Gd-DTPA2-),证明关节内钆增强软骨MR成像(iGEMRIC)及关节软骨T1弛豫成像在体内的可行性。
对5只健康比格犬的双侧后腿膝关节进行MR成像及T1弛豫成像。延迟钆增强软骨MR成像(dGEMRIC)和iGEMRIC技术与MR成像交替进行。对于dGEMRIC,静脉注射双倍常规剂量的Gd-DTPA2-(0.2 mmol/kg)。对于iGEMRIC,在MR成像前,分别将2.5 mmol/l和1.25 mmol/l生理盐水稀释的Gd-DTPA2-溶液注入右膝和左膝关节。从dGEMRIC和iGEMRIC图像中获取20个股骨髁的彩色编码T1图。比较dGEMRIC和iGEMRIC技术在关节软骨的信噪比(SNR)、对比噪声比(CNR)及糖胺聚糖(GAG)描绘方面的差异。
dGEMRIC的平均SNR高于iGEMRIC,但差异无统计学意义(P = 0.174)。尽管dGEMRIC的CNR绝对值更高,但iGEMRIC的平均(±标准差)CNR(-11.6 ± 3.4)高于dGEMRIC(-16.7 ± 4.0;P = 0.000)。iGEMRIC图像上GAG的分层和梯度分布更清晰可见。dGEMRIC和iGEMRIC的GAG描绘平均得分分别为0.7 ± 0.6和2.2 ± 1.7。iGEMRIC方法能更好地显示GAG分布(P = 0.001)。
尽管iGEMRIC和dGEMRIC技术之间的SNR无显著差异,但iGEMRIC生成的彩色编码T1图能更好地评估软骨。因此,iGEMRIC兼具MR关节造影和dGEMRIC的有用特征,并提供了有助于诊断早期关节软骨损伤的彩色编码T1图。