Infectious arthritis can result in serious disability,
so pertinent treatment based on a specific diagnosis is imperative.
[5].
Traditionally,
MR imaging is widely used to diagnose a musculoskeletal infection,
because of its sensitivity in the detection of marrow abnormalities,
soft tissue extent of disease,
and the presence of fluid collections.
[2].
Especially,
bone erosions and marrow edema are highly suggestive of infectious arthritis,
and the added presence of synovial thickening,
synovial edema,
soft tissue edema,
or bone marrow enhancement is even more suggestive of infection [6].
So,
we determine that dynamic contrast-enhanced MR imaging is capable of differentiating infectious and non-infectious joints.
Our study findings show the diagnostic performance of dynamic contrast-enhanced MR imaging for distinguishing between normal and infectious joints on the basis of their distinct enhancement patterns.
The signal intensity-time curve analysis demonstrated that the enhancement pattern in the infectious arthritis were statistically higher maximal slope,
peak value of enhancement and shorter T1/2 max than normal group.
Maybe,
the role of contrast material would have made such differences.
We used contrast-enhanced MR imaging with injection of Gadobutrol (Gadovist®,
Bayer Schering Pharma AG,
Berlin,
Germany) is rapidly distributed in the extracellular space.
Enhancement of signal intensity after intravenous injection of gadolinium-based contrast agents reflects perfusion,
plasma protein content,
permeability and enlargement of the extracellular fluid compartment,
all of which are associated with the activity of inflammatory joint diseases.
The acquisition of dynamic MR imaging is not part of clinical routine in the MR evaluation of inflammatory joint disease.
The use of intravenous contrast agent is very helpful in diagnosing and characterizing inflammatory joint disease [7].
This study strongly supports the view that the early and fast synovial enhancement reflects infectious condition of joints.
So dynamic MRI may prove a clinically useful measure of synovial infection.
Our study had several limitations.
First,
the patient selection may have been biased because only patients referred for MR imaging were examined.
Second,
the enhancement was measured in small circular areas of the synovium,
Finally,
the enhancement values were calculated automatically by our workstation by using the single first image.
In conclusion,
we have shown that dynamic contrast enhanced MR imaging can be a useful imaging modality in the evaluation of musculoskeletal infection.