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01.10.2014 | Musculoskeletal

Aiming for a shorter rheumatoid arthritis MRI protocol: can contrast-enhanced MRI replace T2 for the detection of bone marrow oedema?

verfasst von: Wouter Stomp, Annemarie Krabben, Désirée van der Heijde, Tom W. J. Huizinga, Johan L. Bloem, Annette H. M. van der Helm-van Mil, Monique Reijnierse

Erschienen in: European Radiology | Ausgabe 10/2014

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Abstract

Purpose

To determine whether T1 post-gadolinium chelate images (T1Gd) can replace T2-weighted images (T2) for evaluating bone marrow oedema (BME), thereby allowing a shorter magnetic resonance imaging (MRI) protocol in rheumatoid arthritis (RA).

Material and methods

In 179 early arthritis patients and 43 advanced RA patients, wrist and metacarpophalangeal joints were examined on a 1.5-T extremity MRI system with a standard protocol (coronal T1, T2 fat-saturated and coronal and axial T1 fat-saturated after Gd). BME was scored according to OMERACT RAMRIS by two observers with and without T2 images available. Agreement was assessed using intraclass correlation coefficients (ICCs) for semi-quantitative scores and test characteristics with T2 images as reference.

Results

Agreement between scores based on T2 and T1Gd images was excellent ICC (0.80–0.99). At bone level, sensitivity and specificity of BME on T1Gd compared to T2 were high for both patient groups and both readers (all ≥80 %).

Conclusion

T1Gd and T2 images are equally suitable for evaluating BME. Because contrast is usually administered to assess (teno)synovitis, a short MRI protocol of T1 and T1Gd is sufficient in RA.

Key Points

• Bone marrow oedema scores are equal on T2 and T1-Gd-chelate enhanced sequences.

• Agreement between scores based on T2 and T1-Gd-chelate images was excellent.

• Sensitivity and specificity for presence of bone marrow oedema were high.

• A short protocol without T2 images suffices in rheumatoid arthritis patients.

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Titel: Aiming for a shorter rheumatoid arthritis MRI protocol: can contrast-enhanced MRI replace T2 for the detection of bone marrow oedema?
verfasst von: Wouter Stomp
Annemarie Krabben
Désirée van der Heijde
Tom W. J. Huizinga
Johan L. Bloem
Annette H. M. van der Helm-van Mil
Monique Reijnierse
Publikationsdatum: 01.10.2014
Verlag: Springer Berlin Heidelberg
Erschienen in: European Radiology / Ausgabe 10/2014
Print ISSN: 0938-7994
Elektronische ISSN: 1432-1084
DOI: https://doi.org/10.1007/s00330-014-3272-0

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Aiming for a shorter rheumatoid arthritis MRI protocol: can contrast-enhanced MRI replace T2 for the detection of bone marrow oedema?