Abstract:
HTML
Purpose: MRI depicts conspicuous peri-articular marrow space findings in rheumatoid arthritis that may accompany or predate true bony erosions. We compared these findings as depicted by fat suppressed T2 weighted imaging to those depicted by contrast enhanced T1 weighted imaging, and correlated these findings with erosive disease revealed by CT imaging.
Methods and Materials: Eleven patients with rheumatoid arthritis of <3 years duration underwent imaging of their most affected wrist. Non-enhanced CT was used to acquire 1 mm contiguous axial images of the wrist. MR imaging was performed at 1.5 Tesla using a dedicated wrist receiver coil. Fast spin echo T2 weighted (FSE T2W) MR images were acquired in axial and coronal planes with spectral fat saturation. T1 weighted spin echo images acquired before and after intravenous administration of gadopentetate were used to generate parametric images that displayed percent enhancement (PE). An experienced musculoskeletal radiologist scored imaging exams on a 4 point scale with respect to 15 anatomic zones. The CT score was based on the presence of cortical erosions. The MR scale was based on the extent of marrow signal alteration.
Results: FSE T2W images and PE images were concordant for the presence or absence of a marrow space abnormality in 133/165 zones (81%). 72 zones were concordant for the presence of marrow space abnormalities and 61 zones for the absence of marrow space abnormalities. Of the 32 zones which were discordant for an abnormality by the two MR techniques, FSE T2W images were positive in 12 zones and PE images were positive in 20 zones. This trend toward a higher positive rate for PE images was not significant (p=0.11). Of the 32 zones that were discordant by the two MR techniques, PE images were concordant with CT in 17 zones, while FSE T2W images were concordant with CT in 15 zones (p=0.60).
Conclusion: In patients with rheumatoid arthritis, fat suppressed T2 weighted and contrast enhanced MR imaging sequences depict similar findings in the peri-articular marrow space. The findings on these two types of MR sequences are similarly correlated with erosive disease as revealed by CT.
Yao MD, L,
Marrow Space Findings in Patients with Rheumatoid Arthritis: Fat Suppressed T2-Weighted versus Contrast-enhanced T1-Weighted MR Imaging. Radiological Society of North America 2003 Scientific Assembly and Annual Meeting, November 30 - December 5, 2003 ,Chicago IL.
http://archive.rsna.org/2003/3106846.html
