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Fischer T, Baz YE, Waelti S, et al. Short tau inversion recovery (STIR) after intravenous contrast agent administration obscures bone marrow edema-like signal on forefoot MRI. Skeletal Radiol. 2021;doi: 10.1007/s00256-021-03852-2.
Fischer, T., Baz, Y. E., Waelti, S., Wildermuth, S., Leschka, S., Güsewell, S., & Dietrich, T. J. (2021). Short tau inversion recovery (STIR) after intravenous contrast agent administration obscures bone marrow edema-like signal on forefoot MRI. Skeletal radiology, . https://doi.org/10.1007/s00256-021-03852-2
Fischer, Tim, et al. "Short tau inversion recovery (STIR) after intravenous contrast agent administration obscures bone marrow edema-like signal on forefoot MRI." Skeletal radiology vol. (2021). doi: https://doi.org/10.1007/s00256-021-03852-2
Fischer T, Baz YE, Waelti S, Wildermuth S, Leschka S, Güsewell S, Dietrich TJ. Short tau inversion recovery (STIR) after intravenous contrast agent administration obscures bone marrow edema-like signal on forefoot MRI. Skeletal Radiol. 2021 Jul 13; doi: 10.1007/s00256-021-03852-2. Epub 2021 Jul 13. PMID: 34255126.
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Skeletal Radiol. 2021 Jul 13; doi: 10.1007/s00256-021-03852-2. Epub 2021 Jul 13.

Short tau inversion recovery (STIR) after intravenous contrast agent administration obscures bone marrow edema-like signal on forefoot MRI.

Skeletal radiology

Tim Fischer, Yassir El Baz, Stephan Waelti, Simon Wildermuth, Sebastian Leschka, Sabine Güsewell, Tobias Johannes Dietrich

Affiliations

  1. Division of Radiology and Nuclear Medicine, Kantonsspital St. Gallen, St. Gallen, Switzerland. [email protected].
  2. Faculty of Medicine, University of Zurich, Zurich, Switzerland. [email protected].
  3. Division of Radiology and Nuclear Medicine, Kantonsspital St. Gallen, St. Gallen, Switzerland.
  4. Faculty of Medicine, University of Zurich, Zurich, Switzerland.
  5. Clinical Trials Unit, Kantonsspital St. Gallen, St. Gallen, Switzerland.

PMID: 34255126 DOI: 10.1007/s00256-021-03852-2

Abstract

OBJECTIVE: Short tau or short TI inversion recovery (STIR) MRI sequences are considered a robust fat suppression technique. However, STIR also suppresses signals from other tissues with similar T1 relaxation times. This study investigates the in vivo effect of intravenous gadolinium-based T1-shortening contrast agent on STIR signal.

MATERIALS AND METHODS: Institutional board approval and informed consent was obtained. MRI examinations (1.5-T or 3-T) of 31 prospectively included patients were analyzed by two readers. Signal intensity of degenerative bone marrow edema-like signal at the Lisfranc joint on precontrast STIR images and on STIR images acquired after intravenous contrast agent administration (gadoteric acid, gadolinium: 0.5 mmol/ml, 15 ml) was measured. The medial cuneiform bone without observable bone marrow edema-like signal was considered a healthy tissue and served as a reference. Relative changes in signal intensity between precontrast and postcontrast images were calculated for the two tissues. Wilcoxon signed-rank test served for statistical analyses.

RESULTS: In bone marrow edema-like signal, both readers observed a median signal change of -35% (interquartile range (IQR) 24) and -34% (IQR 21), respectively, on postcontrast STIR images compared to precontrast STIR. In healthy tissue, the signal remained constant on postcontrast STIR images (median change -2%, IQR 15, and 0%, IQR 17) respectively. For both readers, postcontrast signal change in bone marrow edema-like signal differed from that in healthy tissue (p < 0.001).

CONCLUSION: Intravenous gadolinium-based contrast agent causes a significant reduction of signal intensity in bone marrow edema-like signal on routine STIR images. Thus, pathological MRI findings may be obscured.

© 2021. The Author(s).

Keywords: Bone marrow edema-like signal; Contrast media; Foot; Magnetic resonance imaging

References

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