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Detection of rheumatoid arthritis bone erosions by 2 different dedicated extremity MRI units and conventional radiography
  1. Anne Duer-Jensen (anne-duer{at}dadlnet.dk)
  1. Copenhagen University Hospital at Hvidovre, Denmark
    1. Aage Vestergaard
    1. Copenhagen University Hospital at Hvidovre, Denmark
      1. Uffe Møller Døhn
      1. Copenhagen University Hospital at Hvidovre, Denmark
        1. Bo Ejbjerg
        1. Copenhagen University Hospital at Hvidovre, Denmark
          1. Merete Lund Hetland
          1. Copenhagen University Hospital at Hvidovre, Denmark
            1. Elisabeth Albrecht-Beste
            1. Copenhagen University Hospital at Hvidovre, Denmark
              1. Mikkel Østergaard
              1. Copenhagen University Hospital at Hvidovre and Herlev, Denmark

                Abstract

                Objectives: To compare the ability of 2 different dedicated extremity magnetic resonance imaging (E-MRI) units and conventional radiography (CR) for identifying bone erosions in rheumatoid arthritis (RA) metacarpophalangeal (MCP) and wrist joints.

                Methods: CR and 2 MRI-examinations (on 0.2T Esaote Artoscan and 0.2T portable MagneVu MV1000 units) of 418 bones in the dominant wrist and 2.-5. MCP-joints of 15 RA patients and 4 healthy controls were performed and blindedly evaluated for bones being visible and for erosions.

                Results: In MCP-joints, MagneVu visualized 18.5% of bones entirely and 71.1% were 67-99% visualized. In wrists, MagneVu visualized 1.5% of bones entirely, 39.8% were 67-99% visualized and 19% were not visualized at all. Artoscan and CR visualized all bones entirely. Artoscan/MagneVu/CR found 22/19/15 bones with erosions in MCP-joints and 66/40/13 in wrist joints. With the previously validated Artoscan-unit as standard reference, MagneVu and CR had sensitivities of 0.82 and 0.55, respectively, in MCP-joint bones and 0.41 and 0.14 in wrist bones. Specificities of CR and MagneVu were comparable (0.82-0.99). MagneVu was particularly more sensitive than CR in metacarpal heads and carpal bones. MagneVu and CR detected 100% and 89%, respectively, of large erosions (OMERACT-RAMRIS-score > 1 on Artoscan) in MCP-joints, and 69% and 15.8% of large erosions in wrists.

                Conclusions: Both E-MRI units detected more erosions than CR, particularly due to a higher sensitivity in metacarpal heads and carpal bones. The MagneVu detected fewer erosions than the Artoscan, due to a lower average image quality and a smaller proportion of bones being visualized.

                • Magnetic Resonance Imaging
                • erosion
                • extremity
                • radiography
                • rheumatoid arthritis

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