Quiz for MRI in Rheumatology

Delayed gadolinium-enhanced MRI of cartilage (dGEMRIC) is a sequence image to estimate the content of glycosaminoglycan within the hyaline cartilage in the joint. Whole-body MRI scans of the entire body take around 30–45 minutes, especially with newer multichannel technology. T1-weighted and short inversion time recovery (STIR) sequences can be performed. The image of the entire body including the spine, shoulders and arms, anterior chest wall, and pelvis including the SIJ and the lower extremities applies specific planes for specific joints. wbMRI allows simultaneous assessment of peripheral and axial joints. In rheumatology, it is used in the evaluation of spondyloarthritis, pediatric patients with chronic recurrent multifocal osteomyelitis, and in clinical studies to evaluate inflammatory involvement and treatment response in several rheumatic conditions. T2 mapping sequences – used in assessing the joint’s hyaline cartilage collagen fibers and water distribution. It is based on fast spin-echo technology. Diffusion-weighted imaging (DWI) is used in neuroimaging. It is based on the tissue signal attenuation caused by the thermal motion of water molecules in the tissue. Not much is used in rheumatology Dynamic contrast-enhanced technique (DCE) acquire baseline images without contrast enhancement, followed by a series of images acquired over time after an intravenous bolus of contrast material. DCE-MRI provides more than just morphological information. It provides details of the pathophysiological process of information I in inflammation.

Most of the contrast used in MRI are gadolinium-based. Gadolinium has strong paramagnetic ions affecting the relaxation times of nuclei within body tissues and enhancing highly vascularized tissues like tumors or the inflamed synovium. Gadolinium-based are considered safe. The use of contrast in the axial skeleton for detection of sacroiliitis and spondylitis is generally not useful, in contrast to peripheral joints. The cardinal findings of bone marrow edema and structural changes can be detected by T1-weighted and fluid-sensitive sequences without gadolinium contrast.