Kursunoglu-Brahme S, Riccio T, Weisman M H, Resnick D, Zvaifler N, Sanders M E, Fix C
Department of Radiology, University of California Medical Center, San Diego 92103.
Radiology. 1990 Sep;176(3):831-5. doi: 10.1148/radiology.176.3.2389044.
Physical examination is often insufficient in distinguishing between joint effusion and inflamed synovium in the knee joints of patients with rheumatoid arthritis. The authors prospectively evaluated the role of intravenously administered gadopentetate dimeglumine in distinguishing between these two conditions. Fourteen patients with classic rheumatoid arthritis were examined first by a rheumatologist and then by means of magnetic resonance (MR) imaging with T1- and T2-weighted sequences. T1-weighted images were also obtained following the intravenous administration of gadopentetate dimeglumine. T1-weighted images obtained prior to contrast material administration demonstrated an identical low-intensity signal from both effusion and inflamed synovium, and T2-weighted images demonstrated increased signal intensity in both cases. Intravenous administration of gadopentetate dimeglumine allowed distinction between effusion and abnormal synovium, with the effusion remaining of low signal intensity and the synovium demonstrating enhancement and increased signal intensity. The authors conclude that the use of gadopentetate allows distinction between synovial thickening and joint effusion in the knee, which may affect treatment decisions.
在类风湿性关节炎患者的膝关节中，体格检查往往不足以区分关节积液和滑膜炎症。作者前瞻性地评估了静脉注射钆喷酸葡胺在区分这两种情况中的作用。14例典型类风湿性关节炎患者首先由风湿病学家进行检查，然后通过磁共振（MR）成像的T1加权和T2加权序列进行检查。在静脉注射钆喷酸葡胺后也获得了T1加权图像。在注射造影剂之前获得的T1加权图像显示，积液和炎症滑膜均呈现相同的低强度信号，而T2加权图像在两种情况下均显示信号强度增加。静脉注射钆喷酸葡胺能够区分积液和异常滑膜，积液保持低信号强度，而滑膜显示强化和信号强度增加。作者得出结论，使用钆喷酸可以区分膝关节的滑膜增厚和关节积液，这可能会影响治疗决策。
