Indirect MR arthrography: optimization and clinical applications.

Vahlensieck, Martin; Peterfy, Charles; Wischer, Thorsten; Sommer, T.; Lang, Philipp; U, Schlippert; Genant, Harry K.; Schild, H

doi:10.1148/radiology.200.1.8657921

Cited by 117 publications

(64 citation statements)

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“…The contrast agent will distribute into the joint, enhancing synovial fluid and providing greater contrast as well as distension of the capsule, allowing for the interpretation of labrum and cartilage. 49,[57][58][59][60][61] In one study comparing i-MRA and d-MRA, i-MRA showed a sensitivity of 88% and an accuracy of 90%. 62 Byrd et al demonstrated that D-MRA was much more sensitive in the detection of various lesions, however, arthroscopy demonstrated that d-MRA was interpreted falsely positive twice as much compared to i-MRA ( Figure 7).…”

Section: Labrummentioning

confidence: 99%

Magnetic resonance imaging of hip joint cartilage and labrum

Zilkens¹,

Miese²,

Jäger³

et al. 2011

Orthop Rev (Pavia)

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Hip joint instability and impingement are the most common biomechanical risk factors that put the hip joint at risk to develop premature osteoarthritis. Several surgical procedures like periacetabular osteotomy for hip dysplasia or hip arthroscopy or safe surgical hip dislocation for femoroacetabular impingement aim at restoring the hip anatomy. However, the success of joint preserving surgical procedures is limited by the amount of preexisting cartilage damage. Biochemically sensitive MRI techniques like delayed Gadolinium Enhanced MRI of Cartilage (dGEMRIC) might help to monitor the effect of surgical or nonsurgical procedures in the effort to halt or even reverse joint damage.

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Section: Labrummentioning

confidence: 99%

Magnetic resonance imaging of hip joint cartilage and labrum

Zilkens¹,

Miese²,

Jäger³

et al. 2011

Orthop Rev (Pavia)

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“…Este princípio é usado nos estudos por artrografia indireta pela RM, em que, após a injeção do meio de contraste endovenoso e movimentação ativa da articulação em estudo, obtêm-se imagens com líquido articular contendo o contraste paramagnético que atravessa rapidamente a membrana sinovial, chegando no espaço articular (31,33,34) . Em nossos pacientes, uma simples caminhada até o local do exame poderia aumentar a permeabilidade vascular no quadril, mesmo antes Uma outra explicação para esta alteração sinovial seria a correlação com a fase angiogênica do processo inflamatório na AR, em que, histologicamente, há uma hiperplasia da membrana sinovial com proliferação dos linfócitos perivasculares, do tecido necrótico e proliferação das células T e B, sem promover sintomas ao paciente, um estágio que precederia a proliferação sinovial propriamente dita, em que o paciente já apresenta quadro clínico de dor, edema e rigidez matinal, além da caracterização da sinovite pela RM, ultrasonografia ou mesmo a cintilografia (35) .…”

Section: Discussionunclassified

A ressonância magnética do quadril na avaliação de pacientes com artrite reumatóide: estudo descritivo

et al. 2005

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Caldana WCI et al. Radiol Bras 2005;38(4):255260255 extra-articulares como nódulos reumatói-des, alterações oculares e pulmonares, vasculite e pericardite (1). Sua prevalência mundial é de 0,5% a 1% da população , sendo estimada, no Brasil, entre 0,2% e 1,0% OBJETIVO: Avaliar o valor da ressonância magnética (RM) como modalidade diagnóstica de imagem em pacientes com artrite reumatóide e estimar a freqüência das alterações no quadril em pacientes sintomáti-cos e assintomáticos. MATERIAIS E MÉTODOS: Foram avaliados 40 pacientes (17 sintomáticos e 23 assintomáticos) em equipamento de RM com 1,5 T, com o uso do contraste endovenoso. Os achados de RM foram subdivididos em alterações inflamatórias, degenerativas, mistas (inflamatórias e degenerativas) e extraarticulares. RESULTADOS: As alterações mais freqüentes na RM de quadril dos pacientes sintomáticos e assintomáticos foram dos tipos degenerativas (22,5%) e extra-articulares (22,5%). Apenas cinco dos pacientes sintomáticos apresentaram achados inflamatórios (12,5%), sendo quatro (10%) com alterações degenerativas associadas (alterações mistas). CONCLUSÃO: O estudo permitiu avaliar as principais alterações encontradas em pacientes portadores de artrite reumatóide pela RM. As alterações mais freqüentes na RM do quadril desses pacientes foram dos tipos degenerativas e extra-articulares (22,5% de cada grupo). Apenas cinco dos pacientes sintomáticos apresentaram achados inflamatórios (12,5%), sendo quatro (10%) com alterações degenerativas associadas. Unitermos: Ressonância magnética; Quadril; Artrite reumatóide; Adulto.Magnetic resonance imaging of the hip in rheumatoid arthritis patients: a descriptive study. OBJECTIVE: To assess the usefulness of MRI as a diagnostic method in patients with rheumatoid arthritis, and to evaluate the frequency of changes in the hip in symptomatic and asymptomatic patients. MATERIALS AND METHODS: Forty patients (17 symptomatic and 23 asymptomatic) were evaluated by 1.5 T magnetic resonance imaging (MRI) after intravenous contrast media injection. MRI findings were divided in inflammatory, degenerative, combined (inflammatory and degenerative) and extra-articular changes. RESULTS: The most frequent findings seen were degenerative and extra-articular changes (22.5% each). Inflammatory changes were seen in only five (12.5%) symptomatic patients, four of them with degenerative findings associated (10%). CONCLUSION: The use of MRI of the hip allowed the evaluation of the main articular abnormalities seen in patients with rheumatoid arthritis. The most frequent findings were degenerative and extra-articular changes. Inflammatory findings were seen in only five patients, four of them with degenerative changes associated.

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“…Hence, although MRA is not advocated at some centres, many authors suggest MRA as a useful tool to help image the post-operative patient successfully. [8][9][10] CT plays an important role in identifying the position of the sutures and evaluating the osseous structures in the postoperative shoulder. CTA is an alternative to MRI and MRA.…”

Section: Imaging Approachmentioning

confidence: 99%

“…contrast, but in our experience, the use of indirect CTA is limited to the detection of synovitis. 8 Ultrasonography is an excellent alternative modality for evaluating the post-operative rotator cuff, because it is not subject to artefact from metallic implants. 15 Prickett et al 16 showed that ultrasonography has a sensitivity of 91%, a specificity of 89% and an accuracy of 89% for identifying rotator cuff integrity after surgery.…”

Section: Imaging Approachmentioning

confidence: 99%

Complications of rotator cuff surgery—the role of post-operative imaging in patient care

Thakkar¹,

Thakkar²,

Srikumaran³

et al. 2014

BJR

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When pain or disability occurs after rotator cuff surgery, post-operative imaging is frequently performed. Post-operative complications and expected post-operative imaging findings in the shoulder are presented, with a focus on MRI, MR arthrography (MRA) and CT arthrography. MR and CT techniques are available to reduce image degradation secondary to surgical distortions of native anatomy and implant-related artefacts and to define complications after rotator cuff surgery. A useful approach to image the shoulder after surgery is the standard radiography, followed by MRI/MRA for patients with low "metal presence" and CT for patients who have a higher metal presence. However, for the assessment of patients who have undergone surgery for rotator cuff injuries, imaging findings should always be correlated with the clinical presentation because post-operative imaging abnormalities do not necessarily correlate with symptoms.The complexity of the anatomy and function of the rotator cuff makes the rotator cuff tendons vulnerable to considerable morbidity, often necessitating surgical intervention. Optimal management of rotator cuff abnormalities depends on a variety of factors, such as the presence and severity of an impingement, the degree of tendon damage and individual functional demands.1 The goals of rotator cuff surgery are to reduce pain, while simultaneously improving the function. The latter is accomplished by two main types of surgical procedures: (1) subacromial decompression surgery alone, typically with an acromioplasty and/or Mumford procedure (distal clavicular resection); and (2) repair of the rotator cuff tear (open or arthroscopic), which is almost always accompanied by a subacromial decompression.Post-operative imaging is performed when pain or disability occurs after a surgical procedure. Often, however, postoperative imaging is degraded by surgical distortions of the native anatomy and metallic artefacts related to implants. Nevertheless, it is imperative that clinicians have an accurate anatomical delineation of the operative site. It is also important for the radiologist to accurately diagnose complications that might occur after rotator cuff surgery to guide optimal treatment. Mansat et al 2 examined 40 articles reporting the results of open rotator cuff repairs and determined that the overall mean complication rate was 10.5%.The article addresses complications that occur after rotator cuff surgery and expected post-operative imaging findings, with a focus on MRI, MR arthrography (MRA) and CT arthrography (CTA). Because not all post-operative imaging findings result in disability or pain for the patient, we also emphasize our approach and experience regarding how best to define imaging abnormalities after rotator cuff surgery. IMAGING APPROACHA protocol for the imaging of the post-operative shoulder always begins with radiography of the shoulder. The purpose of the radiograph is not only to detect obvious osseous complications, but also to identify the type of surgical procedure performed ...

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Indirect MR arthrography: optimization and clinical applications.

Abstract: Indirect MR arthrography of an exercised joint provides homogeneous enhancement and improved delineation of soft-tissue structures.

Cited by 117 publications

References 0 publications

Magnetic resonance imaging of hip joint cartilage and labrum

Magnetic resonance imaging of hip joint cartilage and labrum

A ressonância magnética do quadril na avaliação de pacientes com artrite reumatóide: estudo descritivo

Complications of rotator cuff surgery—the role of post-operative imaging in patient care

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