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AB0731 Does dynamic contrast-enhanced magnetic resonance (dce-mri) aid the diagnosis of early rheumatoid arthritis in the wrist?
  1. L. Medrud1,
  2. A. Nielsen1,
  3. M. Boesen2,
  4. U. Fredberg3,
  5. T. Ellingsen3
  1. 1Radiology, Diagnostic Centre, Silkeborg Region Hospital, Denmark, Silkeborg
  2. 2Radiology, Frederiksberg, and Bispebjerg University Hospitals, Copenhagen
  3. 3Rheumatology, Diagnostic Centre, Silkeborg Region Hospital, Denmark, Silkeborg, Denmark

Abstract

Background Rheumatoidarthritis (RA) patients are at risk of developing irreversible joint damage. Modern treatment strategies prevent or reduce the permanent joint damage(1). DCE- MRI is a method evaluating perfusions characteristic and might give extra information for the diagnosis.

Objectives Evaluate the clinical consequence of DCE-MRI in early DMARD and steroid naïve RA in the wrist joint, compared to standard-MRI / Ultrasound (US) and clinical evaluation.

Methods Nine patients with early RA by an rheumatologist (2009 ACR/EULAR criteria) were referred to standard-MRI, DCE- MRI and US of the most affected hand before start of treatment.

We used 1.5 T Siemens Avanto Magnetom for the MRI sequences. DCE-MRI is based on sequential acquisition of MRI sequences during infusion of a contrast agent. Active arthritis was defined as: initial rate of enhancement (IRE) > 0,01, maximum enhancement (ME) >1,7 and perfusion with wash out- or plateau pattern in a small region of interest (ROI).

Standard MRI were analyzed using the OMERACT RA MRI scoring system (RAMRIS) (3). Cut –off: synovitis >2, or edema in min. two bones, or edema in one bone and one erosion.

Conclusions The good correlation between arthritis scored by RAMRIS and DCE- MRI resembles findings from the literature (2). Furthermore in two patients DCE- MRI showed sign of inflammation in equivocal cases where RAMRIS could not define arthritis. This suggests DCE- MRI can confirm the clinical diagnosis of arthritis earlier in some patients with early RA.

In a high proportion of patients DCE-MRI and ultrasound gave the same result (8 out of 9). This might be expected because they are both methods for evaluating perfusions characteristic.

  1. Lard LR.JM. Am J Med. 2001 Oct

  2. Boesen M. Rheumatology. 2012 Jan

  3. Østergaard M.Ann Rheum Dis. 2005 Feb

Disclosure of Interest L. Medrud: None Declared, A. Nielsen: None Declared, M. Boesen Consultant for: M Boesen has acted as an independant nonpaid clinical advisor for Image Analysis LTD., U. Fredberg: None Declared, T. Ellingsen: None Declared

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