An MR arthrogram solution is a dilute solution of gadolinium that is used in MR arthrography for injection into the joint prior to imaging. The joint injection is performed under fluoroscopic guidance. A number of recipes are used but a simple approach to preparing 20 mL of solution is as follows:
- 10 mL normal saline
- 0.1 mL gadolinium
- 10 mL nonionic iodinated contrast
The amount of contrast used will depend on the joint. Other preparations include:
- 5 ml solution made up of 0.1 mL gadolinium, 3.5 mL nonionic iodinated contrast, and 1.5 mL 1% lidocaine for shoulder and hip joint injections
- 2.5 ml solution of 0.1 ml gadolinium and 2.5 ml nonionic iodinated contrast for wrist, elbow and ankle injections
- adding lidocaine to the mixture can be done to relieve joint pain due to capsular distension, such pain may remains for 24 to 48 hours after injection
- saline is added to dilute the gadolinium concentration if it is 0.5 (the usual concentration for IV injections), 5 ml of normal saline for 1 ml of 0.5 mL gadolinium
Other radiologists use the same mixture but with some modification in the volume of each component.
Alternatively intra-articular location can be confirmed with iodinated contrast in a separate syringe.
Note: avoid bubbles as they can be confused with intra-articular loose bodies.
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- 2. Maeurer J. Imaging strategies for the shoulder. Thieme Medical Publishers. (2004) ISBN:1588902501. Read it at Google Books - Find it at Amazon