J Korean Radiol Soc.
1981 Sep;17(2):256-259. 10.3348/jkrs.1981.17.2.256.
Epinephrine enhanced double contrast knee arthrography
- KMID: 2463401
- DOI: http://doi.org/10.3348/jkrs.1981.17.2.256
Abstract
- It is well known that double contrast knee arthrography is useful in diagnosis of meniscal lesions and other knee pathology, But intra-articular structures become less well delineated shortly after injection into the kneejoint with water soluble contrast media because of rapid absorption and dilution of the injected media. This limits the time when sharply detailed arthrograms are obtainable and precludes repeat delayed arthrogram withougreinjection of contrast media. In order to overcome this major disadvantage, the authors used epinephrine which has vasoconstrictive effect and is expected to reduce fluid movement across the synovial membrane temporarily. The authors attempted to compare epinephrine inhanced double contrast arthrographic group, einephrine(+) group, to thedouble contrast arthrographic group withoug epinephrine, epinephrine(-) group, by statistical evaluation. Eachgroup consisted of 35 cases and 7 lateral films of knee joint were taken sequentially 2,6,10,15,10,20,30, and 60 minutes after injection of contrast media, and were assessed by 5 certified radiologists. The resuls were as follows; 1. The difference of mean score of quality between epinephrine(+) group and epinephrine(-) group was statistically significant at every time interval (p value<0.01 at 2 minutes, p<0.01 at all other time intervals).Epinephrine(+) group was superior to the epinephrine(-) group in quality of film. 2. Numbers of cases above scoreof 2 which was considered to be of diagnostic quality in evaluating meniscal lesions were larger in epinephrine(+)group than epinephrine(-) group in quality of film. 3. Only 43% of cases was above score of 2 at 10 minutes inepinephrine (-) group, but 97% at 10 minutes and 80% at 20 minutes respectively in epinephrine(+) group. Therefore duration for adequate study of arthrogram is prolonged more than two times in epinephrine(+) group. 4. At 30 minuts, 57% of cases was above score of 2 in epinephrine(+) group while at 15 minuts, 80% of cases was below scoreof 2 in epinephrine(-) group. This makes it possible to repeat study without additional injection of contrast media or postponing of the examination in half of cases, if necessary. 5. The use of epinephrine in kneearthrography results in significant enhancement of radiographic quality initially (p<0.01). Therefore we can fluoroscope in good condition and obtain films of fine quality.
