Purpose
Magnetic resonance imaging (MRI) is one of the mainstay imaging modalities for musculoskeletal (MSK) imaging due to its superb inherent soft-tissue contrast,
spatial resolution,
and the ability to visualise and analyse both normal anatomic structures and pathologic processes.
MSK MRI can be broadly grouped into three categories of disease (1) tumour and tumour-like conditions (2) infection and (3) joint based pathology.
Gadolinium has been considered very safe with serious adverse risks predominately only associated with severe renal impairment.
Contrast enhanced MRI (CEMRI) has been demonstrated...
Methods and Materials
We wanted to gauge the current practices of British and International MSK Radiologists of the use of gadolinium for MSK extra-spinal imaging.
We anonymously surveyed the members of the British Society of Skeletal Radiologists (BSSR),
European Society of Musculoskeletal Radiology (ESSR) and the Musculoskeletal Society of India (MSS).
We present the results along with discussing the role of contrast enhanced MRI in MSK imaging.
Do you use contrast in Musculoskeletal MR Imaging?
Yes
No
Relative proportion of post contrast imaging in your practice?
<25%
25-50%...
Results
Results:
There were 112 responses from BSSR members and 84 responses from ESSR/MSS.
From 112 BSSR survey responses the following question answered breakdown was seen:
Q1.
98 answered; 15 skipped
Q2.
98 answered; 15 skipped
Q3.
99 answered; 14 skipped
Q4.
98 answered; 15 skipped
Q5.
99 answered; 14 skipped
Q6.
97 answered; 16 skipped
Q7.
99 answered; 14 skipped
Q8.
99 answered; 14 skipped
Q9.
112 answered
From 84 ESSR/MS survey responses the following question answered breakdown was seen:
Q1.
83 answered; 1 skipped...
Conclusion
Majority of Radiologists surveyed use gadolinium for extra-axial MSK imaging.
Gadolinium has a role as a problem solver and its use should be restricted to absolutely necessity and where the diagnosis or management is going to change.
For example,
gadolinium use for bone tumour imaging has negligible benefit as seen in Figure 11.
Furthermore,
patients will have bone scans for skip lesions and the contrast resolution and tissue characterisation of unenhanced MRI can often lead to appropriate diagnoses.
Ultrasound plays an important role in the...
References
Carr DH,
Brown J,
Bydder GM et al.
Gadolinium-DTPA as a contrast agent in MRI: initial clinical experience in 20 patients.
AJR Am J Roentgenol 1984;143(2): 215–24.
Lohrke J,
Frenzel T,
Endrikat J et al.
25 years of contrast-enhanced MRI: Developments,
current challenges and future perspectives.
Adv Ther 2016; 33(1): 1–28.
Kanda T,
Fukusato T,
Matsuda M et al.
Gadolinium-based contrast agent accumulates in the brain even in subjects without severe renal dysfunction: evaluation of autopsy brain specimens with inductively coupled plasma mass spectroscopy.
Radiology...
Personal Information
Dr Amit Shah - Consultant Musculoskeletal Radiologist,
University Hospitals of Leicester,
UK.
Dr Rajesh Botchu - Consultant Musculoskeletal Radiologist,
Royal Orthopaedic Hospital,
UK.