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In vivo transport of Gd-DTPA2- into human meniscus and cartilage assessed with delayed gadolinium-enhanced MRI of cartilage (dGEMRIC).

Sigurdsson U, Siversson C, Lammentausta E, Svensson J, Tiderius CJ, Dahlberg LE - BMC Musculoskelet Disord (2014)

Bottom Line: ΔR1 increased until 90-180 minutes in both the cartilage and the meniscus (p < 0.05), and was lower in the medial than in the lateral meniscus at all time points (p < 0.05).A faster increase in ΔR1 was observed in the vascularized peripheral region of the posterior medial meniscus, than in the avascular central part of the posterior medial meniscus during the first 60 minutes (p < 0.05).It is feasible to examine undamaged meniscus and cartilage simultaneously using dGEMRIC, preferably 90 minutes after the injection of a double dose of Gd-DTPA2- (0.2 mmol/kg body weight).

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Orthopaedics, Lund University, Skåne University Hospital, SE-205 02 Malmö, Sweden. ulf.sigurdsson@skane.se.

ABSTRACT

Background: Impaired stability is a risk factor in knee osteoarthritis (OA), where the whole joint and not only the joint cartilage is affected. The meniscus provides joint stability and is involved in the early pathological progress of OA. Delayed gadolinium-enhanced MRI of cartilage (dGEMRIC) has been used to identify pre-radiographic changes in the cartilage in OA, but has been used less commonly to examine the meniscus, and then using only a double dose of the contrast agent. The purpose of this study was to enable improved early OA diagnosis by investigate the temporal contrast agent distribution in the meniscus and femoral cartilage simultaneously, in healthy volunteers, using 3D dGEMRIC at two different doses of the contrast agent Gd-DTPA2-.

Methods: The right knee in 12 asymptomatic volunteers was examined using a 3D Look-Locker sequence on two occasions after an intravenous injection of a double or triple dose of Gd-DTPA2- (0.2 or 0.3 mmol/kg body weight). The relaxation time (T1) and relaxation rate (R1 = 1/T1) were measured in the meniscus and femoral cartilage before, and 60, 90, 120 and 180 minutes after injection, and the change in relaxation rate (ΔR1) was calculated. Paired t-test and Analysis of Variance (ANOVA) were used for statistical evaluation.

Results: The triple dose yielded higher concentrations of Gd-DTPA2- in the meniscus and cartilage than the double dose, but provided no additional information. The observed patterns of ΔR1 were similar for double and triple doses of the contrast agent. ΔR1 was higher in the meniscus than in femoral cartilage in the corresponding compartments at all time points after injection. ΔR1 increased until 90-180 minutes in both the cartilage and the meniscus (p < 0.05), and was lower in the medial than in the lateral meniscus at all time points (p < 0.05). A faster increase in ΔR1 was observed in the vascularized peripheral region of the posterior medial meniscus, than in the avascular central part of the posterior medial meniscus during the first 60 minutes (p < 0.05).

Conclusion: It is feasible to examine undamaged meniscus and cartilage simultaneously using dGEMRIC, preferably 90 minutes after the injection of a double dose of Gd-DTPA2- (0.2 mmol/kg body weight).

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Related in: MedlinePlus

Sagittal view of a knee joint. The average value of T1 was calculated in the following regions of interest: AFC = Anterior Femoral Cartilage, PFC = Posterior Femoral Cartilage, AM = Anterior Meniscus, ACM = Anterior Central Meniscus (inner two-thirds), APM = Anterior Peripheral Meniscus (outer one-third), PM = Posterior Meniscus, PCM = Posterior Central Meniscus (inner two-thirds) and PPM = Posterior Peripheral Meniscus (outer one-third).
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Figure 1: Sagittal view of a knee joint. The average value of T1 was calculated in the following regions of interest: AFC = Anterior Femoral Cartilage, PFC = Posterior Femoral Cartilage, AM = Anterior Meniscus, ACM = Anterior Central Meniscus (inner two-thirds), APM = Anterior Peripheral Meniscus (outer one-third), PM = Posterior Meniscus, PCM = Posterior Central Meniscus (inner two-thirds) and PPM = Posterior Peripheral Meniscus (outer one-third).

Mentions: Two sagittal slices, one in the lateral and one in the medial compartment, were selected from the 3D volume to enable analysis of the weight-bearing parts of the meniscus and femoral cartilage. ROIs were drawn to cover the lateral and medial anterior and posterior regions of the meniscus, and the lateral and medial anterior and posterior femoral cartilage (Figure 1), in accordance with a scheme partly derived from Eckstein et al. [29]. The value of T1 for each ROI was calculated. The meniscus was also divided into a peripheral vascular region (the outer one-third of the meniscus) and a central avascular region (the inner two-thirds of the meniscus) to enable calculations of T1 in these parts of the meniscus (Figure 1). All ROIs were drawn by a single investigator. The paired t-test and analysis of variance (ANOVA) were used for statistical evaluation. The results are presented in the figures as mean values and 95% confidence interval (95% CI). A p-value <0.05 was considered to indicate statistical significance.


In vivo transport of Gd-DTPA2- into human meniscus and cartilage assessed with delayed gadolinium-enhanced MRI of cartilage (dGEMRIC).

Sigurdsson U, Siversson C, Lammentausta E, Svensson J, Tiderius CJ, Dahlberg LE - BMC Musculoskelet Disord (2014)

Sagittal view of a knee joint. The average value of T1 was calculated in the following regions of interest: AFC = Anterior Femoral Cartilage, PFC = Posterior Femoral Cartilage, AM = Anterior Meniscus, ACM = Anterior Central Meniscus (inner two-thirds), APM = Anterior Peripheral Meniscus (outer one-third), PM = Posterior Meniscus, PCM = Posterior Central Meniscus (inner two-thirds) and PPM = Posterior Peripheral Meniscus (outer one-third).
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4125346&req=5

Figure 1: Sagittal view of a knee joint. The average value of T1 was calculated in the following regions of interest: AFC = Anterior Femoral Cartilage, PFC = Posterior Femoral Cartilage, AM = Anterior Meniscus, ACM = Anterior Central Meniscus (inner two-thirds), APM = Anterior Peripheral Meniscus (outer one-third), PM = Posterior Meniscus, PCM = Posterior Central Meniscus (inner two-thirds) and PPM = Posterior Peripheral Meniscus (outer one-third).
Mentions: Two sagittal slices, one in the lateral and one in the medial compartment, were selected from the 3D volume to enable analysis of the weight-bearing parts of the meniscus and femoral cartilage. ROIs were drawn to cover the lateral and medial anterior and posterior regions of the meniscus, and the lateral and medial anterior and posterior femoral cartilage (Figure 1), in accordance with a scheme partly derived from Eckstein et al. [29]. The value of T1 for each ROI was calculated. The meniscus was also divided into a peripheral vascular region (the outer one-third of the meniscus) and a central avascular region (the inner two-thirds of the meniscus) to enable calculations of T1 in these parts of the meniscus (Figure 1). All ROIs were drawn by a single investigator. The paired t-test and analysis of variance (ANOVA) were used for statistical evaluation. The results are presented in the figures as mean values and 95% confidence interval (95% CI). A p-value <0.05 was considered to indicate statistical significance.

Bottom Line: ΔR1 increased until 90-180 minutes in both the cartilage and the meniscus (p < 0.05), and was lower in the medial than in the lateral meniscus at all time points (p < 0.05).A faster increase in ΔR1 was observed in the vascularized peripheral region of the posterior medial meniscus, than in the avascular central part of the posterior medial meniscus during the first 60 minutes (p < 0.05).It is feasible to examine undamaged meniscus and cartilage simultaneously using dGEMRIC, preferably 90 minutes after the injection of a double dose of Gd-DTPA2- (0.2 mmol/kg body weight).

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Orthopaedics, Lund University, Skåne University Hospital, SE-205 02 Malmö, Sweden. ulf.sigurdsson@skane.se.

ABSTRACT

Background: Impaired stability is a risk factor in knee osteoarthritis (OA), where the whole joint and not only the joint cartilage is affected. The meniscus provides joint stability and is involved in the early pathological progress of OA. Delayed gadolinium-enhanced MRI of cartilage (dGEMRIC) has been used to identify pre-radiographic changes in the cartilage in OA, but has been used less commonly to examine the meniscus, and then using only a double dose of the contrast agent. The purpose of this study was to enable improved early OA diagnosis by investigate the temporal contrast agent distribution in the meniscus and femoral cartilage simultaneously, in healthy volunteers, using 3D dGEMRIC at two different doses of the contrast agent Gd-DTPA2-.

Methods: The right knee in 12 asymptomatic volunteers was examined using a 3D Look-Locker sequence on two occasions after an intravenous injection of a double or triple dose of Gd-DTPA2- (0.2 or 0.3 mmol/kg body weight). The relaxation time (T1) and relaxation rate (R1 = 1/T1) were measured in the meniscus and femoral cartilage before, and 60, 90, 120 and 180 minutes after injection, and the change in relaxation rate (ΔR1) was calculated. Paired t-test and Analysis of Variance (ANOVA) were used for statistical evaluation.

Results: The triple dose yielded higher concentrations of Gd-DTPA2- in the meniscus and cartilage than the double dose, but provided no additional information. The observed patterns of ΔR1 were similar for double and triple doses of the contrast agent. ΔR1 was higher in the meniscus than in femoral cartilage in the corresponding compartments at all time points after injection. ΔR1 increased until 90-180 minutes in both the cartilage and the meniscus (p < 0.05), and was lower in the medial than in the lateral meniscus at all time points (p < 0.05). A faster increase in ΔR1 was observed in the vascularized peripheral region of the posterior medial meniscus, than in the avascular central part of the posterior medial meniscus during the first 60 minutes (p < 0.05).

Conclusion: It is feasible to examine undamaged meniscus and cartilage simultaneously using dGEMRIC, preferably 90 minutes after the injection of a double dose of Gd-DTPA2- (0.2 mmol/kg body weight).

Show MeSH
Related in: MedlinePlus