Delayed gadolinium‐enhanced MRI of cartilage (dGEMRIC) and T2 mapping at 3T MRI of the wrist: Feasibility and clinical application. Issue 2 (February 2017) - Rehnitz, Christoph
Abstract : Purpose: To assess the feasibility of delayed gadolinium‐enhanced magnetic resonance imaging (MRI) of cartilage (dGEMRIC) and T 2 mapping for biochemical imaging of the wrist at 3T. Materials and Methods: Seventeen patients with wrist pain (mean age, 41.4 ± 13.1 years) including a subgroup with chondromalacia ( n = 11) and 15 healthy volunteers (26.0 ± 2.2 years) underwent dGEMRIC and T 2 mapping at 3T. For dGEMRIC, the optimum time window after contrast‐injection (gadopentetate dimeglumine) was defined as the plateau of the T 1 curve of repeated measurements 15–90 minutes postinjection and assessed in all volunteers. Reference values of healthy‐appearing cartilage from all individuals and values in areas of chondromalacia were assessed using region‐of‐interest analyses. Receiver‐operating‐characteristic analyses were applied to assess discriminatory ability between damaged and normal cartilage. Results: The optimum time window was 45–90 minutes, and the 60‐minute timepoint was subsequently used. In chondromalacia, dGEMRIC values were lower (551 ± 84 msec, P < 0.001), and T 2 values higher (63.9 ± 17.7, P = 0.001) compared to healthy‐appearing cartilage of the same patient. Areas under the curve did not significantly differ between dGEMRIC (0.91) and T 2 mapping (0.99; P = 0.17). In healthy‐appearing cartilage of volunteers and patients, mean dGEMRIC values were 731.3 ± 47.1 msec and 674.6 ± 72.1 msec ( P = 0.01), and mean T 2 values were 36.5 ± 5 msec and 41.1 ± 3.2 msec ( P = 0.009), respectively. Conclusion: At 3T, dGEMRIC and T 2 mapping are feasible for biochemical cartilage imaging of the wrist. Both techniques allow separation and biochemical assessment of thin opposing cartilage surfaces and can distinguish between healthy and damaged cartilage. J. Magn. Reson. Imaging 2017;45:337–355.