Claudia Schueller-Weidekamm MD, Presenter: Nothing to Disclose

Gabi Gufler, Abstract Co-Author: Nothing to Disclose

Michael Weber PhD, Abstract Co-Author: Nothing to Disclose

Klaus-Peter Lodemann, Abstract Co-Author: Employee, Bracco Group

Johannes Grisar MD, Abstract Co-Author: Nothing to Disclose

Franz M. Kainberger MD, Abstract Co-Author: Nothing to Disclose

To investigate the diagnostic accuracy of a half-dose of Multihance (Bracco, Italy) in the assessment of synovitis in hand and finger joints.

Thirty patients with early rheumatoid arthritis underwent 3 T high-resolution MRI. Coronal T1-weighted TSE and STIR sequences and transversal T2-weighted SE sequences were acquired before contrast media. Coronal T1-weighted TSE sequences with fat saturation were obtained after 0.05 mM/kgKG Multihance (half-dose=HD) with a delay of five minutes. In addition, five minutes later, additional coronal T1-weighted TSE sequences were obtained after a second application of 0.05 mM/kgKG Multihance (full dose=FD) with a another delay of five minutes. The contrast enhancement in the region of interest was measured in inflamed synovial tissue in exactly the same slice on half- and full-dose contrast-enhanced sequences. Differences and the correlation of signal intensities on HD and FD contrast-enhanced sequences were compared using the paired t-test for statistical analysis as well as the Bland-Altman plot.

A statistically significant difference was found for half- and full-dose Multihance in contrast-enhanced synovial tissue (mean: 1184.527 vs. 1363.137; p<0.001). As the signal intensities showed a high correlation between HD and FD (r=0.779), the formula FD= 375.858+0.833*HD can be used to convert HD to FD.

In inflamed synovial tissue, the post contrast signal intensities showed a high correlation between HD and FD. Therefore, HD Multihance is sufficient for the assessment of synovial enhancement in patients with early rheumatoid arthritis with 3T MRI. In regard to clinical relevance, there is no additional information obtained by FD Multihance application.

Synovitis is a predictive factor for bone erosions in patients with Rheumatoid Arthritis (RA). Contrast-enhanced MRI is a sensitive and specific modality for evaluating active synovitis.

Schueller-Weidekamm, C, Gufler, G, Weber, M, Lodemann, K, Grisar, J, Kainberger, F, Contrast-enhanced MR Imaging of Hand and Finger Joints in Patients with Early Rheumatoid Arthritis: Do We Really Need the Full Dose of Multihance for the Assessment of Synovial Enhancement?.  Radiological Society of North America 2010 Scientific Assembly and Annual Meeting, November 28 - December 3, 2010 ,Chicago IL. http://archive.rsna.org/2010/9008474.html