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Indirect MR arthrography: concepts and controversies.

William B Morrison1

  • 1Department of Radiology, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania 19107, USA.

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Summary

Indirect MR arthrography offers a patient-friendly alternative to direct injection, utilizing intravenous Gadolinium contrast. Optimal imaging requires careful timing and awareness of enhanced vascular tissues.

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Area of Science:

  • Radiology
  • Medical Imaging

Background:

  • Indirect MR arthrography uses intravenous Gadolinium contrast for delayed MR imaging.
  • It offers higher patient acceptance compared to direct intra-articular injections.
  • Factors like synovial area and vascularity influence contrast uptake.

Purpose of the Study:

  • To evaluate the efficacy and characteristics of indirect MR arthrography.
  • To compare indirect MR arthrography with direct MR arthrography.
  • To identify factors influencing indirect MR arthrography quality.

Main Methods:

  • Intravenous administration of Gadolinium contrast.
  • Delayed MR imaging after contrast injection.
  • Assessment of factors affecting contrast uptake and image quality.

Main Results:

  • Indirect MR arthrography can yield images similar to direct arthrography.
  • Enhanced vascular tissue within and around the joint is a notable feature.
  • Lack of contrast compartmentalization limits assessment of abnormal joint communications.
  • Suboptimal imaging can result from inadequate contrast diffusion.

Conclusions:

  • Indirect MR arthrography is an attractive alternative due to patient preference and logistical ease.
  • Radiologists must consider the enhancement of vascular tissues.
  • Optimizing image quality depends on adequate time delay and potentially patient exercise.