Sohee Yoon MD, Presenter: Nothing to Disclose

Wook Jin, Abstract Co-Author: Nothing to Disclose

Hyug-Gi Kim, Abstract Co-Author: Nothing to Disclose

Geon-Ho Jahng PhD, Abstract Co-Author: Nothing to Disclose

Seong Jong Yun, Abstract Co-Author: Nothing to Disclose

So Young Park, Abstract Co-Author: Nothing to Disclose

Jung Eun Lee, Abstract Co-Author: Nothing to Disclose

Ji Seon Park MD, PhD, Abstract Co-Author: Nothing to Disclose

Kyung Nam Ryu MD, PhD, Abstract Co-Author: Nothing to Disclose

Previous studies have described higher apparent diffusion coefficient (ADC) values in inflammatory arthritis than degenerative arthritis which may be caused by decreased viscosity. We evaluated the role of diffusion-weighted imaging (DWI) with different b-values in differentiation between infectious, inflammatory and degenerative arthritis.

DWI with b-values of 0, 400and 1400 s/mm2 were obtained in clinically proven 63 arthritis patients with joint effusion (group 1, n = 15 with infectious arthritis; group 2, n = 8 with inflammatory arthritis; group 3, n = 40 with degenerative arthritis). ADCs for each b-value were evaluated. Regions of interest were manually defined in joint fluid areas across several slices with the exception of the synovium to obtain mean ADC values of the joint fluid with two b-values (ADC400 and ADC1400, respectively). Statistical evaluations were performed to test any differences among subject groups and to do those between the two b-values using Kruskal-Wallis test and Wilcoxon signed rank test.

The mean ADCs for joint fluid of groups 1, 2, and 3 were 2.48±0.61x10-3 mm2/s, 2.82±0.60 x10-3 mm2/s and 2.85±0.59 x10-3 mm2/s, respectively, at ADC400 and 1.97±0.58 x10-3 mm2/s, 2.17±0.48 x10-3 mm2/s and 2.46±0.60 x10-3 mm2/s, respectively, at ADC1400. We found significant differences between ADC400 and ADC1400 values in all three groups (P<0.05). The ADC1400 differed significantly between groups 1 and 3(P<0.01) and between groups 2 and 3(P=0.01), but not between groups 1 and 2. The ADC400 showed significant difference only between groups 1 and 3(P<0.05).

We could differentiate group 3 from group 1 or 2 using in vivo DWI with ADC1400. ADC1400 values in group 3 were significantly higher than those in group 1 or 2, presuming the diffusion alternation may be more influenced by cellularity rather than by viscosity. In addition, we found that a high diffusion-sensitizing b-value is important to distinguish between groups.

In vivo DWI with b-values of 1400 s/mm2 of joint fluid plays a role in distinguishing degenerative arthritis from infectious or inflammatory arthritis.

Yoon, S, Jin, W, Kim, H, Jahng, G, Yun, S, Park, S, Lee, J, Park, J, Ryu, K, In vivo Diffusion-weighted MR Imaging of Joint Fluid with Low and High B-values: Potential for Differentiation between Underlying Arthritis.  Radiological Society of North America 2014 Scientific Assembly and Annual Meeting, - ,Chicago IL. http://archive.rsna.org/2014/14016717.html