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Erschienen in:

20.12.2016 | Musculoskeletal

Is there an Added Value of T1-Weighted Contrast-Enhanced Fat-suppressed Spin-Echo MR Sequences Compared to STIR Sequences in MRI of the Foot and Ankle?

verfasst von: Veronika Zubler, Marco Zanetti, Tobias J. Dietrich, Norman Espinosa, Christian W. Pfirrmann, Nadja Mamisch-Saupe

Erschienen in: European Radiology | Ausgabe 8/2017

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Abstract

Objectives

To prospectively compare T1-weighted fat-suppressed spin-echo magnetic resonance (MR) sequences after gadolinium application (T1wGdFS) to STIR sequences in patients with acute and chronic foot pain.

Methods

In 51 patients referred for MRI of the foot and ankle, additional transverse and sagittal T1wGdFS sequences were obtained. Two sets of MR images (standard protocol with STIR or T1wGdFS) were analysed. Diagnosis, diagnostic confidence, and localization of the abnormality were noted. Standard of reference was established by an expert panel of two experienced MSK radiologists and one experienced foot surgeon based on MR images, clinical charts and surgical reports. Patients reported prospectively localization of pain. Descriptive statistics, McNemar test and Kappa test were used.

Results

Diagnostic accuracy with STIR protocol was 80% for reader 1, 67% for reader 2, with contrast-protocol 84%, both readers. Significance was found for reader 2. Diagnostic confidence for reader 1 was 1.7 with STIR, 1.3 with contrast-protocol; reader 2: 2.1/1.7. Significance was found for reader 1. Pain location correlated with STIR sequences in 64% and 52%, with gadolinium sequences in 70% and 71%.

Conclusions

T1-weighted contrast material-enhanced fat-suppressed spin-echo magnetic resonance sequences improve diagnostic accuracy, diagnostic confidence and correlation of MR abnormalities with pain location in MRI of the foot and ankle. However, the additional value is small.

Key Points

• Additional value of contrast-enhanced MR over standard MR with STIR sequences exists.

• There is slightly more added value for soft tissue than for bony lesions.

• This added value is limited.

• Therefore, application of contrast material cannot be generally recommended.

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Bancroft LW, Kransdorf MJ, Adler R et al (2015) ACR appropriateness criteria acute trauma to the foot. J Am Coll Radiol 12:575–581CrossRefPubMed

DeSmet AA, Dalinka MK, Alazraki N et al (2000) Chronic ankle pain. American College of Radiology. ACR appropriateness criteria. Radiology 2000:321–332

Manaster BJ, Dalinka MK, Alazraki N et al (2000) Stress/insufficiency fractures (excluding vertebral). American College of Radiology. ACR Appropriateness Criteria. Radiology 2000:265–272

Rosenberg ZS, Beltran J, Bencardino JT (2000) From the RSNA Refresher Courses. Radiological Society of North America. MR imaging of the ankle and foot. Radiographics 20 Spec No:S153–S179

Stomp W, Krabben A, van der Heijde D et al (2015) Aiming for a simpler early arthritis MRI protocol: can Gd contrast administration be eliminated? Eur Radiol 25:1520–1527CrossRefPubMed

Ostergaard M, Conaghan PG, O'Connor P et al (2009) Reducing invasiveness, duration, and cost of magnetic resonance imaging in rheumatoid arthritis by omitting intravenous contrast injection – does it change the assessment of inflammatory and destructive joint changes by the OMERACT RAMRIS? J Rheumatol 36:1806–1810CrossRefPubMed

Sudol-Szopinska I, Jurik AG, Eshed I et al (2014) Recommendations of the ESSR Arthritis Subcommittee for the Use of Magnetic Resonance Imaging in Musculoskeletal Rheumatic Diseases. Semin Musculoskelet Radiol 19:396–411

Dinoa V, von Ranke F, Costa F, Marchiori E (2016) Evaluation of lesser metatarsophalangeal joint plantar plate tears with contrast-enhanced and fat-suppressed MRI. Skelet Radiol 45:635–644CrossRef

Szeimies U, Staebler A, Walther M (2016) Bildgebende Diagnostik des Fusses. Thieme. ISBN: 9783132403031

10.

Schmid MR, Hodler J, Vienne P, Binkert CA, Zanetti M (2002) Bone marrow abnormalities of foot and ankle: STIR versus T1-weighted contrast-enhanced fat-suppressed spin-echo MR imaging. Radiology 224:463–469CrossRefPubMed

11.

Landis JR, Koch GG (1977) The measurement of observer agreement for categorical data. Biometrics 33:159–174CrossRefPubMed

12.

Brockow K, Sanchez-Borges M (2014) Hypersensitivity to contrast media and dyes. Immunol Allergy Clin N Am 34:547–564, viii CrossRef

13.

Jingu A, Fukuda J, Taketomi-Takahashi A, Tsushima Y (2014) Breakthrough reactions of iodinated and gadolinium contrast media after oral steroid premedication protocol. BMC Med Imaging 14:34CrossRefPubMedPubMedCentral

14.

Thomsen HS, Morcos SK, Almen T et al (2013) Nephrogenic systemic fibrosis and gadolinium-based contrast media: updated ESUR Contrast Medium Safety Committee guidelines. Eur Radiol 23:307–318CrossRefPubMed

15.

de Hooge M, van den Berg R, Navarro-Compan V et al (2013) Magnetic resonance imaging of the sacroiliac joints in the early detection of spondyloarthritis: no added value of gadolinium compared with short tau inversion recovery sequence. Rheumatology (Oxford) 52:1220–1224CrossRef

16.

Lee JW, Suh JS, Huh YM, Moon ES, Kim SJ (2004) Soft tissue impingement syndrome of the ankle: diagnostic efficacy of MRI and clinical results after arthroscopic treatment. Foot Ankle Int 25:896–902CrossRefPubMed

17.

Loeuille D, Sauliere N, Champigneulle J, Rat AC, Blum A, Chary-Valckenaere I (2011) Comparing non-enhanced and enhanced sequences in the assessment of effusion and synovitis in knee OA: associations with clinical, macroscopic and microscopic features. Osteoarthr Cartil 19:1433–1439CrossRefPubMed

Titel: Is there an Added Value of T1-Weighted Contrast-Enhanced Fat-suppressed Spin-Echo MR Sequences Compared to STIR Sequences in MRI of the Foot and Ankle?
verfasst von: Veronika Zubler
Marco Zanetti
Tobias J. Dietrich
Norman Espinosa
Christian W. Pfirrmann
Nadja Mamisch-Saupe
Publikationsdatum: 20.12.2016
Verlag: Springer Berlin Heidelberg
Erschienen in: European Radiology / Ausgabe 8/2017
Print ISSN: 0938-7994
Elektronische ISSN: 1432-1084
DOI: https://doi.org/10.1007/s00330-016-4696-5

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Is there an Added Value of T1-Weighted Contrast-Enhanced Fat-suppressed Spin-Echo MR Sequences Compared to STIR Sequences in MRI of the Foot and Ankle?