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BMC Musculoskeletal Disorders
Published in: BMC Musculoskeletal Disorders 1/2016

Open Access 01-12-2016 | Research article

Delayed gadolinium-enhanced MRI of meniscus (dGEMRIM) and cartilage (dGEMRIC) in healthy knees and in knees with different stages of meniscus pathology

Authors: Ulf Sigurdsson, Gunilla Müller, Carl Siversson, Eveliina Lammentausta, Jonas Svensson, Carl-Johan Tiderius, Leif E. Dahlberg

Published in: BMC Musculoskeletal Disorders | Issue 1/2016

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Abstract

Background

Lesions in the meniscus are risk factors for developing knee osteoarthritis (OA), not least because of the role of the meniscus in the pathological progression of OA. Delayed gadolinium enhanced MRI of cartilage (dGEMRIC) has extensively been used to identify pre-radiographic cartilage changes in OA. In contrast, its counterpart with regard to examination of the meniscus, gadolinium enhanced MRI of meniscus (dGEMRIM), has been less utilized. In this study we use 3D dGEMRIM in patients with meniscus lesions and compare them with previous results of healthy individuals.

Methods

Eighteen subjects with MRI-verified posteromedial meniscus lesions and 12 healthy subjects with non-injured and non-symptomatic knee joints, together 30 volunteers, were examined using 3D Look-Locker sequence after intravenous injection of Gd-DTPA2− (0.2 mmol/kg body weight). Relaxation time (T1) was measured in the posterior meniscus and femoral cartilage before and 60, 90, 120 and 180 min after injection. Relaxation rate (R1 = 1/T1) and change in relaxation rate (ΔR1) were calculated. For statistical analyses, Student’s t-test and Analysis of Variance (ANOVA) were used.

Results

The pre-contrast diagnostic MRI identified two sub-cohorts in the 18 patients with regard to meniscus injury: 1) 11 subjects with MRI verified pathological intrameniscal changes (grade 2) in the posteromedial meniscus only and no obvious cartilage changes. The lateral meniscus showed no pathology. 2) 7 subjects with MRI verified pathological rupture (grade 3) of the posteromedial meniscus and pathological changes in the lateral meniscus and/or medial and lateral joint cartilage.
Comparisons of pathological and healthy posteromedial meniscus revealed opposite patterns in both T1Gd and ΔR1 values between pathological meniscus grade 2 and grade 3. The concentration of the contrast agent was lower than in healthy meniscus in grade 2 lesions (p = 0.046) but tended to increase in grade 3 lesions (p = 0.110). Maximum concentration of contrast agent was reached after 180 min in both cartilage and menisci (except for grade 3 menisci where the maximum concentration was reached after 90 min).

Conclusion

dGEMRIM and dGEMRIC may be feasible to combine in vivo, preferably with one examination before and one 2 h after contrast injection. Possible different dGEMRIM patterns at different stages of meniscus lesions must be taken into account when evaluating meniscus pathology.
Literature
1.
Busija L, Bridgett L, Williams SR, Osborne RH, Buchbinder R, March L, Fransen M. Osteoarthritis. Best Pract Res ClinRheumatol. 2010;24(6):757–68. Review.CrossRef
2.
3.
Proctor CS, Schmidt MB, Whipple RR, Kelly MA, Mow VC. Material properties of the normal medial bovine meniscus. J Orthop Res. 1989;7(6):771–82.CrossRefPubMed
4.
Ghadially FN, Lalonde JM, Wedge JH. Ultrastructure of normal and torn menisci of the human knee joint. J Anat. 1983;136(Pt 4):773–91.
5.
Shrive NG, O’Connor JJ, Goodfellow JW. Load-bearing in the knee joint. ClinOrthopRelat Res. 1978;131:279–87.
6.
Neuman P, Englund M, Kostogiannis I, Fridén T, Roos H, Dahlberg LE. Prevalence of tibiofemoral osteoarthritis 15 years after nonoperative treatment of anterior cruciate ligament injury: a prospective cohort study. Am J Sports Med. 2008;36(9):1717–25.CrossRefPubMed
7.
Berthiaume MJ, Raynauld JP, Martel-Pelletier J, Labonté F, Beaudoin G, Bloch DA, Choquette D, Haraoui B, Altman RD, Hochberg M, Meyer JM, Cline GA, Pelletier JP. Meniscal tear and extrusion are strongly associated with progression of symptomatic knee osteoarthritis as assessed by quantitative magnetic resonance imaging. Ann Rheum Dis. 2005;64(4):556–63.CrossRefPubMed
8.
Boegård TRO, Petersson IF, Jonsson K. Joint-space width in the weight-bearing radiogram of the tibiofemoral joint. Should the patient stand on one leg or two? ActaRadiol. 1998;39(1):32–5.
9.
Davies AP, Calder DA, Marshall T, Glasgow MM. Plain radiography in the degenerate knee. A case for change. J Bone Joint Surg (Br). 1999;81(4):632–5.CrossRef
10.
Poole AR, Rizkalla G, Ionescu M, Reiner A, Brooks E, Rorabeck C, Bourne R, Bogoch E. Osteoarthritis in the human knee: a dynamic process of cartilage matrix degradation, synthesis and reorganization. Agents Actions Suppl. 1993;39:3–13.CrossRefPubMed
11.
Pernin J, Verdonk P, Selmi TAS, Massin P, Neyret P. Long-term follow-up of 24.5 years after intra-articular anterior cruciate ligament reconstruction with lateral extra-articular augmentation. Am J Sports Med. 2010;38(6):1094–102.CrossRefPubMed
12.
Tiderius CJ, Jessel R, Kim YJ, Burstein D. Hip dGEMRIC in asymptomatic volunteers and patients with early osteoarthritis: the influence of timing after contrast injection. MagnResonMed. 2007;57:803–5.CrossRef
13.
Sigurdsson U, Siversson C, Lammentausta E, Svensson J, Tiderius CJ, Dahlberg LE. In vivo transport of Gd-DTPA2- into human meniscus and cartilage assessed with delayed gadolinium-enhanced MRI of cartilage (dGEMRIC). MusculoskeletDisord. 2014;15:226.
14.
Sun Y, Mauerhan DR, Kneisl JS, James Norton H, Zinchenko N, Ingram J, Hanley Jr EN, Gruber HE. Histological examination of collagen and proteoglycan changes in osteoarthritic menisci. Open Rheumatol J. 2012;6:24–32.CrossRefPubMedPubMedCentral
15.
Peters TJ, Smillie IS. Studies on the chemical composition of the menisci of the knee joint with special reference to the horizontal cleavage lesion. ClinOrthopRelat Res. 1972;86:245–52.
16.
17.
van Tiel J, Kotek G, Reijman M, Bos PK, Bron EE, Klein S, Verhaar JA, Krestin GP, Weinans H, Oei EH. Delayed gadolinium-enhanced MRI of the meniscus (dGEMRIM) in patients with knee osteoarthritis: relation with meniscal degeneration on conventional MRI, reproducibility, and correlation with dGEMRIC. EurRadiol. 2014;24(9):2261–70.
18.
Li W, Edelman RR, Prasad PV. Delayed contrast enhanced MRI of meniscus with ionic and non-ionic agents. J MagnReson Imaging. 2011;33(3):731–5.CrossRef
19.
Lotysch M, Mink J, Crues JV, Schwartz SA. Magnetic resonance imaging in the detection of meniscal injuries. MagnReson Imaging. 1986;4:94.
20.
Siversson C, Tiderius CJ, Dahlberg L, Svensson J. Local Flip Angle Correction for Improved Volume T1-Qantification in Three-Dimensional dGEMRIC Using the Look-Locker Technique. J MagnReson Imaging. 2009;30:834–41.CrossRef
21.
Eckstein F, Ateshian G, Burgkart R, Burstein D, Cicuttini F, Dardzinski B, Gray M, Link TM, Majumdar S, Mosher T, Peterfy C, Totterman S, Waterton J, Winalski S, Felson D. Proposal for a nomenclature for magnetic resonance imaging based measures of articular cartilage in osteoarthritis. Osteoarthritis Cartilage. 2006;14(10):974–83.CrossRefPubMed
22.
Ghosh P, Ingman AM, Taylor TK. Variations in collagen, non-collagenous proteins, and hexosamine in menisci derived from osteoarthritic and rheumatoid arthritic knee joints. J Rheumatol. 1975;2(1):100–7.PubMed
23.
Tiderius CJ, Olsson LE, de Verdier H, Leander P, Ekberg O, Dahlberg L. Gd-DTPA2)-enhanced MRI of femoral knee cartilage: a dose–response study in healthy volunteers. MagnReson Med. 2001;46(6):1067–71.CrossRef
24.
25.
Akeson WH, Amiel DA, Gershuni DH. Articular cartilage physiology and metabolism. In: Resnick D, editor. Diagnosis of bone and joint disorders. 3rd ed. Philadelphia: WB Saunders; 1995. p. 769–90.
26.
McDermott ID, Sharifi F, Bull AM, Gupte CM, Thomas RW, Amis AA. An anatomical study of meniscal allograft sizing. Knee Surg Sports TraumatolArthrosc. 2004;12(2):130–5.CrossRef
27.
Li W, Scheidegger R, Wu Y, Edelman RR, Farley M, Krishnan N, Burstein D, Prasad PV. Delayed contrast-enhanced MRI of cartilage: comparison of nonionic and ionic contrast agents. MagnReson Med. 2010;64(5):1267–73.CrossRef
28.
Hawezi ZK, Lammentausta E, Svensson J, Dahlberg LE, Tiderius CJ. In vivo transport of Gd-DTPA2- in human knee cartilage assessed by depth-wise dGEMRIC analysis. J MagnReson Imaging. 2011;34(6):1352–8.CrossRef
29.
Weinmann HJ, Laniado M, Mützel W. Pharmacokinetics of GdDTPA/dimeglumine after intravenous injection into healthy volunteers. PhysiolChem Phys Med NMR. 1984;16(2):167–72.
30.
Grobner T. Gadolinium a specific trigger for the development of nephrogenic fibrosingdermopathy and nephrogenic systemic fibrosis? Nephrol Dial Transplant. 2006;21:1104–8.CrossRefPubMed
31.
Martin DR, Krishnamoorthy SK, Kalb B. Decreased incidence of NSF in patients on dialysis after changing gadolinium contrast-enhanced MRI protocols. J MagnReson Imaging. 2010;31:440–6.CrossRef
32.
Wang Y, Alkasab TK, Narin O. Incidence of nephrogenic systemic fibrosis after adoption of restrictive gadolinium-based contrast agent guidelines. Radiology. 2011;260:105–11.CrossRefPubMed
Metadata
Title
Delayed gadolinium-enhanced MRI of meniscus (dGEMRIM) and cartilage (dGEMRIC) in healthy knees and in knees with different stages of meniscus pathology
Authors
Ulf Sigurdsson
Gunilla Müller
Carl Siversson
Eveliina Lammentausta
Jonas Svensson
Carl-Johan Tiderius
Leif E. Dahlberg
Publication date
01-12-2016
Publisher
BioMed Central
Published in
BMC Musculoskeletal Disorders / Issue 1/2016
Electronic ISSN: 1471-2474
DOI
https://doi.org/10.1186/s12891-016-1244-z

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