Comparing non-enhanced and enhanced sequences in the assessment of effusion and synovitis in knee OA: associations with clinical, macroscopic and microscopic features

Abstract

T2w sequences are adequate in assessing effusion volume in compare to joint volume by arthrocentesis but only T1wCE sequences are able to detect synovitis according to the reference of synovial biopsy.

Osteoarthritis year 2012 in review: imaging

“…The study found that T2w sequences were adequate to assess effusion volume but that only contrast-enhanced MRI could detect histologically proven synovitis ( Fig. 2) 11 . The role of contrast-enhanced MRI for synovitis assessment has also been emphasized by other research groups and seems to be gaining acceptance in the OA imaging community 12,13 .…”

Imaging of osteoarthritis (OA): What is new?

“…Due to possible side effects and associated costs, it would be desirable not to use contrast-enhanced MRI in OA studies; however its use does improve the certainty of detecting inflamed synovium [42], which has been related to pain and shown to predict progression of radiographic JSN [36,41].…”

“…to assess inflammation using signal changes in Hoffa's fat pad and intra-articular fluid assessment; the latter has been validated against synovial fluid volume measured by arthrocentesis [42]. MRI-detected effusion increases the risk of cartilage loss and pain [44], and a change in synovitis and effusion has been related to concurrent change in pain [45].…”

The application of T2W SPIR-FLAIR in the diagnosis of hip synovitis in patients with spondyloarthritis

“…The signals of the thickened synovial membranes and the intra-articular fluids are similar and cannot be distinguished from each other using the conventional nonenhanced MRI sequences. [12][13][14] The diagnosis of synovitis relies on the presence of intra-articular effusion on nonenhanced MR sequence images. 12,13 However, normal articular cavity contains a small amount of synovia.…”

“…The thickened synovial membranes during the acute phases of synovitis show a significant abnormal enhancement on the enhanced T1W SPIR images, while the intra-articular fluids do not show enhancement. 13,14 Although the enhanced T1W SPIR sequence can distinguish thickened synovial membranes from intra-articular fluids (the normal synovia and effusion), it requires the injection of contrast agents, which increases the health care costs of patients and introduces the risk of contrast agent allergy and nephrogenic systemic fibrosis in patients with kidney dysfunction. 15,16 T 2 weighted (T2W) SPIR sequence is commonly used in the observation of acute inflammation.…”