Delayed gadolinium-enhanced magnetic resonance imaging of cartilage in knee osteoarthritis: Findings at different radiographic stages of disease and relationship to malalignment

Ashley Williams, Leena Sharma, Charles A. McKenzie, Pottumarthi V. Prasad, Deborah Burstein*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

139 Scopus citations

Abstract

Objective. Delayed gadolinium-enhanced magnetic resonance imaging (MRI) of cartilage (dGEMRIC) is used to examine the distribution of glycosaminoglycan in cartilage. This study sought to characterize dGEMRIC in the evaluation of knee osteoarthritis (OA) according to various radiographically determined disease parameters, a nd to examine the relationship between alignment of the knee joint and the lateral:medial dGEMRIC ratio. Methods. Thirty-one patients with knee OA underwent MRI with a dGEMRIC protocol at 1.5T. Semi-flexed knee radiographs and full-limb radiographs were also obtained for assessment of alignment. Results. Compartments of the knee joint without joint space narrowing had a higher dGEMRIC index than those with any level of narrowing (mean 408 msec versus 365 msec; P = 0.001). In knees with 1 unnarrowed (spared) and 1 narrowed (diseased) compartment, the dGEMRIC index was greater in the spared versus the diseased compartment (mean 395 msec versus 369 msec; P = 0.001). In spared compartments, there was a trend toward a lower dGEMRIC index with increasing Kellgren/Lawrence (K/L) radiographic severity grade; the spared compartments of knees with a K/L grade 2 had a higher dGEMRIC index than those of knees with a K/L grade 4 (mean 425 msec versus 371 msec; P < 0.05). There was a range of dGEMRIC values in the spared compartments within a given K/L grade, demonstrating biochemical differentiation of disease in radiographically comparable compartments. Almost all compartments with narrowing had dGEMRIC indices of <400 msec. Valgus-aligned knees tended to have lower dGEMRIC values laterally, and varus-aligned knees tended to have lower dGEMRIC values medially; as a continuous variable, alignment correlated with the lateral:media) dGEMRIC ratio (Pearson's R = 0.43, P = 0.02). Conclusion. The biochemical information provided by dGEMRIC scans may augment radiography by improving the differentiation of disease status within a given radiographic grade, especially in early OA.

Original languageEnglish (US)
Pages (from-to)3528-3535
Number of pages8
JournalArthritis and rheumatism
Volume52
Issue number11
DOIs
StatePublished - Nov 2005

ASJC Scopus subject areas

  • Immunology and Allergy
  • Rheumatology
  • Immunology
  • Pharmacology (medical)

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