Assessing Synovitis and Bone Erosion With Apparent Diffusion Coefficient in Early Stage of Rheumatoid Arthritis

Qu, Jin Ping; Lei, Xinwei; Zhan, Yanhui; Li, Huixia

doi:10.1097/rct.0000000000000609

Cited by 6 publications

(13 citation statements)

References 27 publications

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“…11,12 Our results support previous studies demonstrating that, in the hands of patients with arthritis, ADC values permit differentiation between synovitis and joint effusion, which present with differing states of water molecule diffusion (ie, the water molecules in areas of synovial proliferation move less restrictively than those in areas of joint effusion). 12 IVIM parameter D values were significantly different when comparing between contrast enhancement grades indicative of synovial proliferation and those indicative of joint effusion, and showed slightly favorable relationship with them than ADC values. DWI images with three b-values greater than 200 s/mm 2 are required for calculating the D value, thereby contributing to extended scanning time by around 1 minute compared with ADC with two b-values.…”

Section: Discussionsupporting

confidence: 88%

“…DWI is a noninvasive imaging technique that permits visualization of the restricted diffusion of water molecules, and is useful for the assessment of synovitis in RA . Our results support previous studies demonstrating that, in the hands of patients with arthritis, ADC values permit differentiation between synovitis and joint effusion, which present with differing states of water molecule diffusion (ie, the water molecules in areas of synovial proliferation move less restrictively than those in areas of joint effusion) …”

Section: Discussionsupporting

confidence: 86%

“…Some researchers have demonstrated that diffusion‐weighted imaging (DWI) presents a noninvasive approach to contrast‐free imaging of synovitis in RA . Qu et al showed that the apparent diffusion coefficient (ADC) from the transverse DWI can be used to differentiate between synovitis and joint effusion in the hands of RA patients due to differences in water molecule diffusion …”

mentioning

confidence: 99%

“…9,10 Some researchers have demonstrated that diffusionweighted imaging (DWI) presents a noninvasive approach to contrast-free imaging of synovitis in RA. 11,12 Qu et al showed that the apparent diffusion coefficient (ADC) from the transverse DWI can be used to differentiate between synovitis and joint effusion in the hands of RA patients due to differences in water molecule diffusion. 12 Intravoxel incoherent motion (IVIM) analysis, as originally described by Le Bihan et al, is a method based on DWI with multiple b values that assumes a relationship between the signal intensity and the b value.…”

mentioning

confidence: 99%

“…11,12 Qu et al showed that the apparent diffusion coefficient (ADC) from the transverse DWI can be used to differentiate between synovitis and joint effusion in the hands of RA patients due to differences in water molecule diffusion. 12 Intravoxel incoherent motion (IVIM) analysis, as originally described by Le Bihan et al, is a method based on DWI with multiple b values that assumes a relationship between the signal intensity and the b value. 13 IVIM simultaneously permits quantification of both diffusion and perfusion using a single imaging study, without the need for intravenous contrast injection.…”

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confidence: 99%

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Intravoxel incoherent motion MRI for discrimination of synovial proliferation in the hand arthritis: A prospective proof‐of‐concept study

Fujimori

Murakami

Sugimori

et al. 2019

Magnetic Resonance Imaging

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Background Postcontrast‐enhanced MRI is currently the reference standard for synovial proliferation in rheumatoid arthritis (RA). However, the technique is somewhat invasive due to the use of gadolinium contrast agents, which may cause severe adverse/side effects. Intravoxel incoherent motion (IVIM) simultaneously permits quantification of perfusion as well as diffusion using a single imaging scan. Purpose/Hypothesis To test the capability of IVIM MRI for noninvasive discrimination of synovial proliferation in hand arthritis. Study Type Prospective. Subjects Seven suspected RA patients (three women and four men; mean age, 61 years; range, 26–74 years). Field Strength/Sequence 3 T/short tau inversion recovery (STIR), IVIM, postcontrast‐enhanced MRI. Assessment Region of interest (ROI) was identified based on STIR. Contrast‐enhanced MRI was evaluated using a 5‐point grading scale of 0 (water) to 4 (synovial proliferation) according to the degree of contrast enhancement within the ROI. For each ROI, we calculated the apparent diffusion coefficient (ADC) and IVIM parameters (molecular diffusion coefficient [D], perfusion fraction [f], and perfusion‐related diffusion coefficient [D*]). These parameters were subsequently compared with ROI contrast enhancement grades. Statistical Tests Spearman's rank correlation test and a receiver operating characteristic (ROC) curve. Results A total of 90 ROIs of suspected synovial proliferation and/or joint effusion were identified. ROI grades were correlated with ADC and D values (r S = –0.385, P < 0.001, r S = –0.458, P < 0.0001, respectively), but not with the f and D* values (r S = –0.010, P = 0.936, r S = –0.084, P = 0.505, respectively). The area under the curves (AUCs) of D values (0.708–0.888, P = 0.002–0.0002) were slightly larger than those of ADC values (0.692–0.791, P = 0.013–0.001) when comparing low‐ vs. high‐contrast enhancement grades. Data Conclusion The IVIM parameter D and ADC may be useful for the noninvasive identification of synovial proliferation in hand arthritis. Level of Evidence: 2 Technical Efficacy Stage: 2 J. Magn. Reson. Imaging 2019;50:1199–1206.

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Section: Discussionsupporting

confidence: 88%

Section: Discussionsupporting

confidence: 86%

mentioning

confidence: 99%

mentioning

confidence: 99%

mentioning

confidence: 99%

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Intravoxel incoherent motion MRI for discrimination of synovial proliferation in the hand arthritis: A prospective proof‐of‐concept study

Fujimori

Murakami

Sugimori

et al. 2019

Magnetic Resonance Imaging

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Lesions of Bones and Joints Associated with Rheumatism

Zhou¹,

Wang²,

Yuan³

et al. 2022

Radiology of Infectious and Inflammatory Diseases - Volume 5

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MRI and ultrasound of the hands and wrists in rheumatoid arthritis. I. Imaging findings

Rubin

2019

Skeletal Radiol

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The management of patients with rheumatoid arthritis (RA) has rapidly evolved with the development of newer diseasemodifying drugs and the recognition that long-term damage can be mitigated by an earlier and more-informed use of these medications. Historically, radiographs were the mainstay of imaging in RA patients, but radiographic joint narrowing and erosions are late and insensitive findings in the disease. MRI (with intravenous contrast agent) and ultrasound (with power Doppler interrogation) of the hands and wrists are able to demonstrate erosions earlier and with greater sensitivity than radiographs. More importantly, these imaging studies also depict synovitis and active soft-tissue inflammation, which represents a precursor to structural damage. Additionally, MRI can show inflammation within the bones (osteitis), which is proving to be the most important prognosticator of an aggressive disease course. Part I of this review discusses the imaging techniques, pitfalls, definitions, and comparative studies of MRI and ultrasound for identifying and quantifying erosions, synovitis, and osteitis. Part II will demonstrate how these imaging findings influence the clinical management of RA patients throughout their disease course, from presentation through clinical remission.

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Assessing Synovitis and Bone Erosion With Apparent Diffusion Coefficient in Early Stage of Rheumatoid Arthritis

Abstract: Apparent diffusion coefficient can be used in differentiating between synovitis and joint effusion and between bone erosion and cysts.

Cited by 6 publications

References 27 publications

Intravoxel incoherent motion MRI for discrimination of synovial proliferation in the hand arthritis: A prospective proof‐of‐concept study

Intravoxel incoherent motion MRI for discrimination of synovial proliferation in the hand arthritis: A prospective proof‐of‐concept study

Lesions of Bones and Joints Associated with Rheumatism

MRI and ultrasound of the hands and wrists in rheumatoid arthritis. I. Imaging findings

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