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

作者：Stomp Wouter^*; Krabben Annemarie; van der Heijde Desiree; Huizinga Tom W J; Bloem Johan L; van der Helm van Mil Annette H M; Reijnierse Monique

来源：European Radiology, 2014, 24(10): 2614-2622.

DOI：10.1007/s00330-014-3272-0

• Arthritis
• Rheumatoid arthritis
• Magnetic resonance imaging
• Bone marrow
• Contrast media
• Gadolinium

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).
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.
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 a parts per thousand yen80 %).
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.
aEuro cent Bone marrow oedema scores are equal on T2 and T1-Gd-chelate enhanced sequences.
aEuro cent Agreement between scores based on T2 and T1-Gd-chelate images was excellent.
aEuro cent Sensitivity and specificity for presence of bone marrow oedema were high.
aEuro cent A short protocol without T2 images suffices in rheumatoid arthritis patients.

• 出版日期2014-10