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.
Lard LR.JM. Am J Med. 2001 Oct
Boesen M. Rheumatology. 2012 Jan
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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