MR arthrography: pharmacology, efficacy and safety in clinical trials

Abstract

The diagnostic efficacy of intra-articular MRA in most clinical conditions affecting major joints is greater than that of plain MRI. In some diagnostic problems MRA achieves almost the same sensitivity and specificity as the surgical gold standard. Given a sterile application, the intra-articular administration of Gd-DTPA in a concentration of 2 mmol/l prior to MRI is a safe procedure.

Comparison study of intraarticular and intravenous gadolinium-enhanced magnetic resonance imaging of cartilage in a canine model

“…MR arthrography has been used to evaluate the articular cartilage of joints for more than 10 years (14)(15)(16)(17)(18)(19). Direct MR arthrography with the injection of a dilute solution of gadolinium directly into the joint (iGEMRIC) improves the visualization of cartilage, owing to the contrast between cartilage and the injected fluid (1,44).…”

“…Assuming that iGEMRIC would have the features and benefits of both dGEMRIC and MR arthrography, we investigated the feasibility of iGEMRIC and T1 relaxation mapping of articular cartilage in vivo using the intraarticular injection of Gd-DTPA 22 . Depending on the pulse sequence chosen, the maximum signal intensity measured in in vitro experiments occurs at gadolinium concentrations between 0.5 and 2.5 mmol/l (14,50,51). However, the applied contrast medium can be diluted in vivo by existing inflammatory or trauma-related effusion (14).…”

Radiological Assessment of the Shoulder Region

“…It is considered the gold standard imaging method in the evaluation of shoulder instability and labral tears (Figure 7) (28,29). In addition, if there is suspicion of a rotator cuff tear and conventional MRI examination is inconclusive, MR arthrography should be performed.…”

Ligamentos dos processos talares posterior e lateral: ressonância magnética e artro-ressonância magnética do tornozelo e da articulação subtalar posterior com correlação anatômica e histológica

“…Dentre as desvantagens da artro-RM observam-se a sua natureza invasiva, aumento do tempo de exame e complicações extremamente raras, como a infecção (Schulte-Altedorneburg et al, 2003;Cerezal et al, 2005).…”

“…Heterogeneidade de sinal e aspecto estriado podem ser notados em alguns ligamentos devido à presença de gordura entre seus fascículos Schneck et al, 1992;Rosenberg et al, 2000;Bencardino e Rosenberg, 2001;Schulte-Altedorneburg et al, 2003;Narvaez et al, 2003).…”