Gunilla Müller MD, Presenter: Nothing to Disclose

Sven Månsson PhD, Abstract Co-Author: Consultant, AstraZeneca PLC

Markus F. Muller MD, Abstract Co-Author: Nothing to Disclose

Olle Torgny Ekberg MD, Abstract Co-Author: Nothing to Disclose

Anders Björkman DMD, Abstract Co-Author: Nothing to Disclose

To measure the vulnerable perfusion of the carpal bones and determine its normal range in volunteers as a standard of reference for patients with possible carpal bone necrosis.

19 healthy volunteers were examined on a 3-T scanner (Trio TIM, Siemens) with dynamic i.v. gadolinium contrast medium injection (0.1 mmol/kg, Dotarem, Guerbet). The slice position was determined using scout images in 3 planes to ensure accurate selection of medullary bone. Three sagittal image sections were placed in a folding fan-like arrangement. 23 consecutive T1-w GRE FS images, each with duration of 20 s, were acquired, resulting in a total acquisition time of 6 min and 40 s. Gd-injection was started at the end of the first image azquisition. The increase in signal intensity over time was measured in four ROIs placed over the distal and proximal poles of the scaphoid bone, the lunate bone, and the capitate bone, respectively. A gamma-variate-like function were fitted to the data and the maximum enhancement, maximum slope, and time to peak were calculated.  

All volunteers demonstrated a contrast uptake in all bones (mean±SD): capitatum 83±41%, lunatum 74±35%, proximal scaphoideum 59±42%, distal scaphoideum 64±44%. The maximum enhancement in capitatum was significantly higher than in both proximal and distal scaphoideum (p<0.05). No significant differences were found in maximum slope and time to peak between the bones.

Dynamic gadolinium enhanced MRI was able to demonstrate the normal perfusion of the scaphoid, lunate and capitate bones.

The vascular supply of the scaphoid, lunate and capitate bones has unique patterns, placing them at risk for osteonecrosis. Early detection of altered perfusion may allow a more favorable treatment.

Müller, G, Månsson, S, Muller, M, Ekberg, O, Björkman, A, Folding Fan Image Acquisition in 3 T MRI to Measure Carpal Perfusion.  Radiological Society of North America 2011 Scientific Assembly and Annual Meeting, November 26 - December 2, 2011 ,Chicago IL. http://archive.rsna.org/2011/11016612.html