Gadolinium-enhanced MR imaging of the wrist in rheumatoid arthritis : value of fat suppression pulse sequences

To determine the usefulness of fat-suppressed gadolinium (Gd)-enhanced MR imaging of the wrist in patients with rheumatoid arthritis (RA). Fat-suppressed Gd-enhanced T1-weighted spin-echo (SE) images were obtained and compared with other standard techniques in 38 wrists of 27 patients (22-77 years)...

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Bibliographic Details
Published in:Skeletal radiology 1996-10, Vol.25 (7), p.639-647
Main Authors: NAKAHARA, N, UETANI, M, HAYASHI, K, KAWAHARA, Y, MATSUMOTO, T, ODA, J
Format: Article
Language:English
Subjects:
Adult
Aged
Arthritis, Rheumatoid - blood
Arthritis, Rheumatoid - diagnosis
Biological and medical sciences
Blood Sedimentation
Bone Marrow - pathology
C-Reactive Protein - analysis
Contrast Media
Female
Gadolinium
Humans
Image Enhancement
Investigative techniques, diagnostic techniques (general aspects)
Magnetic Resonance Imaging - methods
Male
Medical sciences
Middle Aged
Osteoarticular system. Muscles
Radiodiagnosis. Nmr imagery. Nmr spectrometry
Synovial Membrane - pathology
Wrist Joint - pathology
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Summary:To determine the usefulness of fat-suppressed gadolinium (Gd)-enhanced MR imaging of the wrist in patients with rheumatoid arthritis (RA). Fat-suppressed Gd-enhanced T1-weighted spin-echo (SE) images were obtained and compared with other standard techniques in 38 wrists of 27 patients (22-77 years) with RA. Scoring based on the degree of synovial enhancement of each joint was developed and the total scores (J-score) were correlated with radiographic stage, C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), and symptomatic change in the follow-up study. Synovial proliferations showed marked enhancement in all the wrists. In addition, contrast enhancement in the bone marrow and tenosynovium was seen in 36 and eight wrists respectively. Fat-suppressed Gd-enhanced T1-weighted images demonstrated these abnormalities better than other techniques. The J-scores correlated well with values of CRP (P = 0.0034), but not with radiographic stages and ESR. Fat-suppressed Gd-enhanced T1-weighted SE images can clearly demonstrate most of the essential lesions in RA including the proliferative synovium, bone erosion, bone marrow inflammatory change, and tenosynovitis. Scoring based on the extent of Gd-enhancement of synovium can be useful in the assessment of the inflammatory status.
ISSN:0364-2348
1432-2161
DOI:10.1007/s002560050151