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Hemodialysis-related arthropathy. A prospective MR study with SE and GRE sequences
1Department of Radiology, Shinshu University School of Medicine, Matsumoto, Japan.
Purpose:
A prospective examination of hemodialysis-related arthropathy by MR imaging with SE and GRE sequences was undertaken to verify whether the low signal intensity on T2-weighted SE images is caused by a paramagnetic susceptibility effect derived from amyloid or from hemosiderin.
Material And Methods:
Twenty-seven joints (19 hip joints, 6 discovertebral joints of 5 lumbosacral spines and 1 cervical spine, 2 shoulder joints) in 14 patients undergoing long-term hemodialysis (duration 10-22 years, mean 17) were examined with SE T1-weighted, T2-weighted and GRE T2*-weighted sequences.
Results:
The signal intensity of the intraarticular and periarticular masses of the involved joints was basically isointense to the muscle in all 3 pulse sequences. No significantly low signal area was found on GRE T2*-weighted images.
Conclusion:
The low signal areas in the hemodialysis-related arthropathy on SE T2-weighted images are not caused by a paramagnetic susceptibility effect, but probably by the hypocellular and fibrous nature of amyloid-containing tissues. Therefore the GRE sequence can be helpful for differentiating hemodialysis-related amyloid arthropathy from chronic hemarthrosis or juxta-articular brown tumor.
Insights
Low signal intensity in hemodialysis-related arthropathy on MRI is not due to paramagnetic effects. This finding helps differentiate amyloid arthropathy from other joint conditions using GRE sequences.
Area of Science:
- Radiology
- Orthopedics
- Rheumatology
Background:
- Hemodialysis patients can develop arthropathy.
- Distinguishing the cause of joint abnormalities is crucial for effective treatment.
Purpose of the Study:
- To investigate the cause of low signal intensity in hemodialysis-related arthropathy on T2-weighted SE MR images.
- To determine if amyloid or hemosiderin causes this signal change.
Main Methods:
- Prospective MR imaging study of 27 joints in 14 long-term hemodialysis patients.
- Utilized SE T1-weighted, T2-weighted, and GRE T2*-weighted sequences.
Main Results:
- Intraarticular and periarticular masses were isointense to muscle across all sequences.
- No significantly low signal areas were detected on GRE T2*-weighted images.
Conclusions:
- Low signal areas on SE T2-weighted images are likely due to the fibrous nature of amyloid, not paramagnetic effects.
- GRE sequences aid in differentiating hemodialysis-related amyloid arthropathy from chronic hemarthrosis or brown tumors.