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Contrast enhanced gray-scale sonography in assessment of joint vascularity in rheumatoid arthritis: results from the IACUS study group

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Abstract

The purpose of this study way to assess the value of contrast enhanced gray-scale ultrasound (CEUS) in detection of vascularity in joints of patients with rheumatoid arthritis (RA) in a multicenter study of the International Arthritis Contrast Ultrasound (IACUS) study group. We assessed 113 joints in 113 patients (44 men, 69 women; mean age 51±14 years) with clinical diagnosis of RA. Gray-scale ultrasound (US), power Doppler US (PDUS) and CEUS, using a low mechanical index US technique, was performed. CEUS was done by bolus administration of the contrast agent SonoVue (Bracco, Milan, Italy) with a dosage of 4.8-ml SonoVue flushed with 10 ml saline. Detection of joint vascularity was performed for differentiation of active synovitis from inactive intra-articular thickening (synovitis/effusion). With the use of US and PDUS, active synovitis could be differentiated from inactive intra-articular thickening in 68/113 joints (60.1%), whereas CEUS enabled differentiation in 110/113 (97.3%) joints (p<0.0001). Thickness measurement of active synovitis was significantly improved after contrast administration (p=0.008). In conclusion, CEUS improves the differentiation of active synovitis from inactive intra-articular thickening. Since CEUS has shown an ability to improve assessment of vascularized synovial proliferation in RA affected joints, this technique may have further potential in monitoring therapy.

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Authors and Affiliations

  1. Department of Radiology II and Internal Medicine, Medical University Innsbruck, Innsbruck, 6020, Austria

    Andrea Klauser & Michael Schirmer

  2. Clinic for Diagnostic Radiology and Neuroradiology, Zentralklinikum Augsburg, Augsburg, 86156, Germany

    Johannes Demharter, Timm Kleffel & Klaus Bohndorf

  3. Department of Radiology, Adelaide C.T.O. Hospitals, Torino, 10128, Italy

    Armanda De Marchi & Carlo Faletti

  4. Department of Radiology, Hospital Vall d’Hebron, Barcelona, 08035, Spain

    Delia Sureda

  5. Department of Radiology, University of L’Aquila, L’Aquila, 67101, Italy

    Antonio Barile & Carlo Masciocchi

Authors
  1. Andrea Klauser
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  2. Johannes Demharter
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  3. Armanda De Marchi
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  4. Delia Sureda
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  5. Antonio Barile
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  6. Carlo Masciocchi
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  7. Carlo Faletti
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  8. Michael Schirmer
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  9. Timm Kleffel
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  10. Klaus Bohndorf
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Correspondence to Andrea Klauser.

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Klauser, A., Demharter, J., De Marchi, A. et al. Contrast enhanced gray-scale sonography in assessment of joint vascularity in rheumatoid arthritis: results from the IACUS study group. Eur Radiol 15, 2404–2410 (2005). https://doi.org/10.1007/s00330-005-2884-9

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  • DOI: https://doi.org/10.1007/s00330-005-2884-9

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