HEMODIALYSIS-RELATED ARTHROPATHY - A PROSPECTIVE MR STUDY WITH SE ANDGRE SEQUENCES

Purpose: A prospective examination of hemodialysis-related arthropathy by MR imaging with SE and GRE sequences was under taken to verify whe ther the low signal intensity on T2-weightrd SE images is caused by a paramagnetic susceptibility effect derived from amyloid or from hemosi derin. Material and Methods: Twenty-seven joints (19 hip joints, 6 dis covertebral joints of 5 lumbosacral spines and 1 cervical spine, 2 sho ulder joints) in 14 patients undergoing long-term hemodialysis (durati on 10-22 years, mean 17) were examined with SE T1-weighted, T2-weighte d and GRE T2-weighted sequences. Results: The signal intensity of the intraarticular and periarticular masses of the involved joints was ba sically isointense to the muscle in all 3 pulse sequences. No signific antly low signal area was found on GRE T2-weighted images. Conclusion : The low signal areas in the hemodialysis-related arthropathy on SE T 2-weighted images are not caused by a paramagnetic susceptibility effe ct, but probably by the hypocellular and fibrous nature of amyloid-con taining tissues. Therefore the GRE sequence can be helpful for differe ntiating hemodialysis-related amyloid arthropathy from chronic hemarth rosis or juxta-articular brown tumor.