Power Doppler sonography with and without echo-enhancing contrast agent and contrast-enhanced MRI for the evaluation of rheumatoid arthritis of the shoulder joint: differentiation between synovitis and joint effusion

G, Wamser; Bohndorf, Klaus; Vollert, Kurt; Bücklein, W.; Schalm, J.

doi:10.1007/s00256-003-0632-2

Cited by 59 publications

(34 citation statements)

References 24 publications

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“…Limited diagnostic value in the characterization of intraarticular thickening by US contrast application can be also due to technical problems and the use of first generation US contrast agents [20,21]. We were able to overcome these problems in this multicenter study by the use of a second generation US contrast agent, the standardization of examination protocols, dedicated US contrast machine equipment, and optimized contrast settings.However, we have to admit that contrast enhanced US was limited in those 3 cases (2.6%) where only MRI or histological examination would have added additional information.…”

Section: Discussionmentioning

confidence: 99%

Contrast enhanced gray-scale sonography in assessment of joint vascularity in rheumatoid arthritis: results from the IACUS study group

et al. 2005

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The purpose of this study way to assess the value of contrast enhanced gray-scale ultrasound (CEUS) in detection of vascularity in joints of patients with rheumatoid arthritis (RA) in a multicenter study of the International Arthritis Contrast Ultrasound (IACUS) study group. We assessed 113 joints in 113 patients (44 men, 69 women; mean age 51+/-14 years) with clinical diagnosis of RA. Gray-scale ultrasound (US), power Doppler US (PDUS) and CEUS, using a low mechanical index US technique, was performed. CEUS was done by bolus administration of the contrast agent SonoVue (Bracco, Milan, Italy) with a dosage of 4.8-ml SonoVue flushed with 10 ml saline. Detection of joint vascularity was performed for differentiation of active synovitis from inactive intra-articular thickening (synovitis/effusion). With the use of US and PDUS, active synovitis could be differentiated from inactive intra-articular thickening in 68/113 joints (60.1%), whereas CEUS enabled differentiation in 110/113 (97.3%) joints (p<0.0001). Thickness measurement of active synovitis was significantly improved after contrast administration (p=0.008). In conclusion, CEUS improves the differentiation of active synovitis from inactive intra-articular thickening. Since CEUS has shown an ability to improve assessment of vascularized synovial proliferation in RA affected joints, this technique may have further potential in monitoring therapy.

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Section: Discussionmentioning

confidence: 99%

Contrast enhanced gray-scale sonography in assessment of joint vascularity in rheumatoid arthritis: results from the IACUS study group

et al. 2005

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“…14,15,38 Use of contrast agents enhances visualization of the small synovial vessels by color or power Doppler ultrasound, and enables accurate characterization of the rheumatoid pannus, which may be hypervascular, hypovascular, or avascular. 14,15,39 In 2005, the International Arthritis Contrast Ultrasound group undertook a multicenter study comparing contrastenhanced ultrasound versus grayscale and power Doppler ultrasound for detection of joint vascularity in patients with rheumatoid disease. Contrast-enhanced ultrasound was found to be helpful for differentiating between active synovitis and inactive intra-articular thickening, and for improving measurement of the thickness of inflamed synovial tissue.…”

Section: Contrast-enhanced Color/power Dopplermentioning

confidence: 99%

“…Studies comparing contrast-enhanced power Doppler and MRI in the evaluation of synovitis have yielded inconsistent results. 39,42,43 An important aspect to bear in mind is that there is a limited window of opportunity for performing a contrast-enhanced power Doppler ultrasound examination with Levovist because of rapid destruction of microbubbles with a high mechanical index, resulting in a decrease in signal intensity with time. 44 The mean molecular diameter of Levovist is about 3 µm, 45 and no extravasation into the surrounding tissues is found, indicating that Levovist acts as an intravascular contrast agent.…”

Section: Contrast-enhanced Color/power Dopplermentioning

confidence: 99%

Doppler ultrasound imaging techniques for assessment of synovial inflammation

Filippucci¹,

Salaffi²,

Carotti³

et al. 2013

RMI

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Abstract:Ultrasound is an evolving technique, and the rapid progress made in ultrasound technology over the past ten years has dramatically increased its range of applications in rheumatology. One of the most exciting advances is the use of Doppler ultrasound imaging in the assessment of blood flow abnormalities at the synovial tissue level in patients with chronic inflammatory arthritis. This review describes the Doppler techniques available and their main applications in patients with inflammatory arthritis, discusses the evidence supporting their use, and outlines the latest advances in hardware and software. Spectral, color, and power Doppler allow sensitive assessment of vascular abnormalities at the synovial tissue level. Use of contrast agents enhances visualization of the small synovial vessels using color or power Doppler ultrasound and allows for accurate characterization of the rheumatoid pannus. Doppler techniques represent a unique method for assessment of synovial inflammation, showing blood flow characteristics in real time. They are safe, noninvasive, cost-effective, and have high sensitivity in revealing and monitoring synovitis. However, several questions still need to be answered. In the near future, the Doppler techniques described here, together with upcoming hardware and software facilities, will be investigated further and a consensus will be reached on their feasibility and appropriate use in daily rheumatologic practice.

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“…Studien mit Levovist®, einem Echoverstärker der ersten Generation hat am Knie und an den MCP-Gelenken von RA-Patienten gute Korrelationen zur Klinik, zum Labor und im Vergleich zur MRT mit Kontrastmittel gezeigt [10,15,36,41]. Keine Korrelation fand man an der Schulter im Vergleich zur MRT mit dem Kontrastverstärker Levovist® bei RAPatienten [40].…”

Section: Einsatz Von Echokontrastverstärkern In Der Früh Arthritisdiaunclassified

Neue Entwicklungen in der Gelenksonographie

2006

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Musculoskeletal ultrasonography has become an established imaging technique in rheumatology. The ability of ultrasonography to visualize soft tissue changes provides a possibility for differentiating between exudative and proliferative synovial tissue changes. Superficial cartilage and bone lesions can be detected earlier by ultrasonography than by conventional radiography. The application of Doppler and power Doppler ultrasonography is helpful for the detection of early inflammation. Current studies with ultrasound contrast media demonstrate its benefit in the differentiation of inflammatory processes. Musculoskeletal ultrasonography is helpful in the diagnosis of early arthritis, especially in patients with inconspicuous conventional radiography or suspicious clinical findings. It is a convenient method for follow-up analysis, and therefore has an impact on the monitoring of therapy. It is patient-friendly and is an important tool for the diagnostic work-up of arthritis.

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Power Doppler sonography with and without echo-enhancing contrast agent and contrast-enhanced MRI for the evaluation of rheumatoid arthritis of the shoulder joint: differentiation between synovitis and joint effusion

Abstract: Using MRI as the "gold standard," PD sonography with and without echo-enhancing contrast agent cannot reliably identify synovitis or distinguish synovial inflammation from effusion in the shoulder joint.

Cited by 59 publications

References 24 publications

Contrast enhanced gray-scale sonography in assessment of joint vascularity in rheumatoid arthritis: results from the IACUS study group

Contrast enhanced gray-scale sonography in assessment of joint vascularity in rheumatoid arthritis: results from the IACUS study group

Doppler ultrasound imaging techniques for assessment of synovial inflammation

Neue Entwicklungen in der Gelenksonographie

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