Andrea Klauser MD, Presenter: Nothing to Disclose

Tobias DeZordo MD, Abstract Co-Author: Nothing to Disclose

Johann Gradl MD, Abstract Co-Author: Nothing to Disclose

Paul Rhomberg, Abstract Co-Author: Nothing to Disclose

Matthias P. Schurich MD, Abstract Co-Author: Nothing to Disclose

Gudrun Feuchtner MD, Abstract Co-Author: Nothing to Disclose

Contrast Enhanced grey- scale Ultrasound (CEUS) has contributed to improved detection of synovial vascularity associated with disease activity in Rheumatoid Arthritis (RA). Therefore the purpose was to compare vascularity detection in synovial proliferations of RA patients assessed by two different US machines, both capable for contrast enhanced gray scale sonography.

Eighteen joints in 18 consecutive patients (8 men, 10 women; mean age 42 ± 9 years) with clinical diagnosis of RA were assessed by CEUS by one musculoskeletal radiologist during 1 patient visit using two different US units. CEUS was performed after 2 bolus administration of 2,4 mL of the contrast agent SonoVue® (Bracco, Milan, Italy) for each US unit examination (MPX Technos and Mylab 30 Esaote, Genoa, Italy). For both examinations setting as frequency and scanning plane using the same transducer (LA532E), were kept constant. Quantitative estimation of joint vascularity was performed by calculation of time-intensity curves. In a different session two musculoskeletal radiologists performed image interpretation.

Findings of high peak enhancement was found in 12/18 joints, whereas low plateau enhancement were seen in 4/18 joints and no enhancement at all in 2/18 joints in both examinations. Good intrascanner correlation was found for CEUS (r=0.95, p0.89, p<0.005).

CEUS in handheld US systems is sensitive to the presence of joint vascularity associated with RA compared to the high-end system and therefore seems promising for a sensitive monitoring of disease activity in joints of patient with RA.

Sensitive detection of vascularity on the microvascular level is important to improve disease activity assessment in RA. New treatment strategies (TNF alpha inhibitors) target the microvascular level, therefore CEUS because of its sensitivity is more and more important in rheumatology. The use of handheld could further add for clinical routine assessment of vascularity in RA patients.

Klauser, A, DeZordo, T, Gradl, J, Rhomberg, P, Schurich, M, Feuchtner, G, Contrast-enhanced Grey-scale Ultrasound in the Assessment of Joint Vascularity in Rheumatoid Arthritis: Comparison of Findings between a Handheld and High End US System.  Radiological Society of North America 2007 Scientific Assembly and Annual Meeting, November 25 - November 30, 2007 ,Chicago IL. http://archive.rsna.org/2007/5016735.html