European Radiology

, Volume 28, Issue 2, pp 459–467 | Cite as

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

  • Ye Na Son
  • Wook JinEmail author
  • Geon-Ho Jahng
  • Jang Gyu Cha
  • Yong Sung Park
  • Seong Jong Yun
  • So Young Park
  • Ji Seon Park
  • Kyung Nam Ryu



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 (κ = 0.736) for the four-point scale, and was excellent for the location of the thickest synovium on DIR and CET1FS (κ = 0.955 and 0.954). The intersequential agreement for the area with the thickest synovium was also excellent (κ = 0.845 and κ = 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.

Key Points

• DIR can be useful for evaluating the synovium of the femoro-patellar joint.

• Interobserver and intersequential agreements between DIR and CET1FS were good.

• Mean thickness of the synovium was significantly different between two sequences.


Knee Synovium Double inversion recovery Magnetic resonance imaging Contrast enhancement 



Contrast-enhanced T1-weighted fat-saturated


Contrast-to-noise ratio


Double inversion recovery


Synovium-to-bone signal ratio


Synovium-to-effusion signal ratio


Compliance with ethical standards


The scientific guarantor of this publication is Wook Jin.

Conflict of interest

The authors of this manuscript declare no relationships with any companies whose products or services may be related to the subject matter of the article.


This study has received funding by the Basic Science Research Program through the National Research Foundation of Korea (NRF) funded by the Ministry of Education, Science and Technology (Grant No. 2009-0089314).

Statistics and biometry

One of the authors has significant statistical expertise.

Informed consent

Written informed consent was waived by the Institutional Review Board.

Ethical approval

Institutional Review Board approval was obtained.


• retrospective

• diagnostic or prognostic study

• performed at one institution


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Copyright information

© European Society of Radiology 2017

Authors and Affiliations

  • Ye Na Son
    • 1
  • Wook Jin
    • 1
    Email author
  • Geon-Ho Jahng
    • 1
  • Jang Gyu Cha
    • 2
  • Yong Sung Park
    • 1
  • Seong Jong Yun
    • 1
    • 3
  • So Young Park
    • 1
  • Ji Seon Park
    • 4
  • Kyung Nam Ryu
    • 4
  1. 1.Department of Radiology, Kyung Hee University Hospital at GangdongKyung Hee University School of MedicineSeoulKorea
  2. 2.Department of RadiologySoonchunhyang University Bucheon HospitalBucheon-siKorea
  3. 3.Department of Radiology, Aerospace Medical Center, Republic of Korea Air ForceCheongwon-gunKorea
  4. 4.Department of RadiologyKyung Hee University HospitalSeoulKorea

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