To show the feasibility of delayed Gadolinium-enhanced MRI of Cartilage (dGEMRIC) and T2 mapping at the wrists in healthy volunteers and in patients with wrist pain including establishing the optimal time-interval after contrast injection (dGEMRIC), evaluation of normal values of healthy cartilage and values of cartilage damage (dGEMRIC and T2 mapping).

Fifteen healthy volunteers (mean age, 26.0 ± 2.2 years) and 17 patients with wrist pain (mean age, 41.4± 13.1 years) were examined at 3 Tesla MRI. For dGEMRIC a 3D dual flip VIBE sequence before and after intravenous administration of gadopentetatedimeglumine (0.2 mmol/kg) and for T2 mapping a multi-echo-spin-echo T2-weighted sequence were performed. dGEMRICsequences were repeated at 15, 30, 45, 60, 75 and 90 minutes after contrast injection in all 15 volunteers. The optimal time-intervalwas defined asthe period of steady state of contrast agent penetrating...

Optimal time point for dGEMRIC (Fig 2): The T1 values showed a significant decrease between initial measurement and all 15-minute time-points until 45 minutes. Between 45 and final 90 minutes the differences were not significant, i.e. the optimal time-interval for dGEMRIC-measurement was between 45-90 min after contrast-injection. To be definitely within theoptimal time-interval and a clinically reasonable time-frame the 60 min time-point was chosenfor further measurements. NormaldGEMRIC values for healthy-appearing cartilage in volunteerswere at t=60 min 731.3 (mean)+- 47.1 ms andsignificantly lower in patients (mean,...

At 3 Tesla, dGEMRIC and T2 mapping are feasible at the wrist despite the thin cartilage. Normal values are provided. Reduced dGEMRIC and increased T2 mapping values in normal-appearing cartilage of patients may indicate early cartilage damage. Similar to other joints both techniques are able to detect GAG-loss and increased water content in areas of chondromalacia with non-superiority of either technique in ROC-analysis. T2 mapping and dGEMRIC may be used as an additional tool in difficult cases such as preoperatively before proximal row carpectomy to...

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Christoph Rehnitz, MD Consultant Section Musculoskeletal Radiology Diagnostic and Interventional Radiology University of Heidelberg Email: [email protected]