Efficacy of double inversion recovery magnetic resonance imaging for the evaluation of the synovium in the femoro-patellar joint without contrast enhancement

To investigate the efficacy of double inversion recovery (DIR) sequence for evaluating the synovium of the femoro-patellar joint without contrast enhancement (CE). Two radiologists independently evaluated the axial DIR and CE T1-weighted fat-saturated (CET1FS) images of 33 knees for agreement; the visualisation and distribution of the synovium were evaluated using a four-point visual scaling system at each of the five levels of the femoro-patellar joint and the location of the thickest synovium. The maximal synovial thickness at each sequence was measured by consensus. The interobserver agreement was good (kappa = 0.736) for the four-point scale, and was excellent for the location of the thickest synovium on DIR and CET1FS (kappa = 0.955 and 0.954). The intersequential agreement for the area with the thickest synovium was also excellent (kappa = 0.845 and kappa = 0.828). The synovial thickness on each sequence showed excellent correlation (r = 0.872). The DIR showed as good a correlation as CET1FS for the evaluation of the synovium at the femoro-patellar joint. DIR may be a useful MR technique for evaluating the synovium without CE. aEuro cent DIR can be useful for evaluating the synovium of the femoro-patellar joint. aEuro cent Interobserver and intersequential agreements between DIR and CET1FS were good. aEuro cent Mean thickness of the synovium was significantly different between two sequences.