HEMOPHILIC ARTHROPATHY OF THE KNEE-JOINT - STATIC AND DYNAMIC GD-DTPA- ENHANCED MRI

A total of 17 patients with hemophilic arthropathy of the knee joint w ere studied with static and dynamic MRI before and after an IV bolus i njection of Gadolinium-DTPA (Gd-DTPA; 0.1 mmol/kg body weight). The T1 -weighted spin-echo (SE) and gradient-echo (fast-field echo [FFE] sequ ences were applied. The FFE sequences of eight consecutive scans carri ed out over a time interval of 160 s were used in order to determine t he time to signal intensity (SI) curves of the synovial proliferations surrounding soft tissue, bone marrow, and joint effusion. After the a dministration of a contrast agent, synovial proliferations exhibited a n increase on FFE and SE images of 47.7% (SD +/- 14.3%) and 37.4% (SD +/- 11.2%), respectively, whereas muscle and fatty tissue, tendons, bo ne marrow, and joint effusion revealed only a minor increase in SI. Th e gradient of SI (ratio SI/time) of pannus was 39.6%/min (SD +/- 7.7%/ min) and differed significantly (P<0.001) from that of bone marrow, fa tty tissue, muscle tissue, tendons, and joint effusion (P<0.05). In co ntrast to synovial proliferations in rheumatoid arthritis, no differen tiation between various pannus vascularities based on the degree of en hancement was possible. The Gd-DTPA-enhanced MRI studies delineate and quantify the synovial proliferations in hemophilic arthropathy. Dynam ic studies in hemophilic arthropathy do not provide qualitative assess ment of the inflammatory process.