MRI wrist in early rheumatoid arthritis: reduction in inflammation assessed quantitatively during treatment period correlates best with clinical improvement
- 26 November 2020
- journal article
- research article
- Published by Springer Science and Business Media LLC in Skeletal Radiology
- Vol. 50 (7), 1337-1345
- https://doi.org/10.1007/s00256-020-03669-5
Abstract
Objective To investigate (a) which MR features of inflammation (synovitis, tenosynovitis, perfusion) correlate with clinical/serological features in early rheumatoid arthritis (ERA) before, during and after 1 year of treatment and (b) whether quantitative or semi-quantitative measures of inflammation on magnetic resonance imaging (MRI) provides the highest correlation in this regard. Method One hundred one ERA patients (76 females, 25 males, mean age, 53 ± 12 years) underwent clinical/serological testing and 3 T dynamic contrast-enhanced MRI of the most symptomatic wrist. Seventy-seven of the 101 patients completed 1 year of treatment, followed by repeat MR examination. Clinical/serological parameters were correlated with semi-quantitative/quantitative MR measures of inflammation at baseline, during and after 1 year of treatment. Spearman’s correlation was applied. Results Quantitative measures of inflammation correlated better with clinical/serological parameters than semi-quantitative measures, with the highest correlations being for relative change during treatment. Pain reduction correlated with reduced tenosynovitis volume (r = 0.41). Reduction in disease activity correlated with reduction in synovitis volume (r = 0.66) or synovial perfusion parameters (r = 0.58). Decrease in early morning stiffness correlated with decrease in perfusion parameters (r = 0.46). Reduction in ESR and CRP correlated with decrease in synovial volume (r = 0.40 and r = 0.41, respectively). Conclusion In ERA patients, quantitative assessment of inflammation on MRI correlated better with clinical parameters than semi-quantitative assessment. Relative change during treatment yielded the highest correlation. Decrease in tenosynovitis correlated best with reduction in pain while decrease in synovitis volume and perfusion correlated best with reduction in disease activity, early morning stiffness (perfusion), or serological parameters (synovitis volume).Keywords
This publication has 34 references indexed in Scilit:
- Bone marrow edema and osteitis in rheumatoid arthritis: the imaging perspectiveArthritis Research & Therapy, 2012
- 2010 Rheumatoid arthritis classification criteria: an American College of Rheumatology/European League Against Rheumatism collaborative initiativeAnnals Of The Rheumatic Diseases, 2010
- Rapid reduction in tenosynovitis of the wrist and fingers evaluated by MRI in patients with rheumatoid arthritis after treatment with etanerceptAnnals Of The Rheumatic Diseases, 2010
- The Many Myths of Erythrocyte Sedimentation Rate and C-Reactive ProteinThe Journal of Rheumatology, 2009
- The use of MRI in early RARheumatology, 2008
- Presence of significant synovitis in rheumatoid arthritis patients with disease‐modifying antirheumatic drug–induced clinical remission: Evidence from an imaging study may explain structural progressionArthritis & Rheumatism, 2006
- User-guided 3D active contour segmentation of anatomical structures: Significantly improved efficiency and reliabilityNeuroImage, 2006
- An introduction to the EULAR-OMERACT rheumatoid arthritis MRI reference image atlasAnnals Of The Rheumatic Diseases, 2005
- Relationship between inflammation and joint destruction in early rheumatoid arthritis: a mathematical descriptionAnnals Of The Rheumatic Diseases, 2004
- THE OPTIMAL MANAGEMENT OF EARLY RHEUMATOID DISEASE: THE KEY TO PREVENTING DISABILITYRheumatology, 1994