Prediction of radiographic progression in synovitis-positive joints on maximum intensity projection of magnetic resonance imaging in rheumatoid arthritis |
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Authors: | Takanori Akai Daigo Taniguchi Ryo Oda Maki Asada Shogo Toyama Daisaku Tokunaga Takahiro Seno Yutaka Kawahito Yosuke Fujii Hirotoshi Ito Hiroyoshi Fujiwara Toshikazu Kubo |
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Affiliation: | 1.Department of Orthopaedics, Graduate School of Medical Science,Kyoto Prefectural University of Medicine,Kyoto,Japan;2.Department of Inflammation and Immunology, Graduate School of Medical Science,Kyoto Prefectural University of Medicine,Kyoto,Japan;3.Department of Rheumatic Diseases and Joint Function,Kyoto Prefectural University of Medicine,Kyoto,Japan;4.Statistical Genetics, Center for Genomic Medicine,Kyoto University Graduate School of Medicine,Kyoto,Japan;5.Department of Diagnostic Radiology,Kajiicho Medical Imaging Center,Kyoto,Japan |
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Abstract: | Contrast-enhanced magnetic resonance imaging with maximum intensity projection (MRI-MIP) is an easy, useful imaging method to evaluate synovitis in rheumatoid hands. However, the prognosis of synovitis-positive joints on MRI-MIP has not been clarified. The aim of this study was to evaluate the relationship between synovitis visualized by MRI-MIP and joint destruction on X-rays in rheumatoid hands. The wrists, metacarpophalangeal (MP) joints, and proximal interphalangeal (PIP) joints of both hands (500 joints in total) were evaluated in 25 rheumatoid arthritis (RA) patients. Synovitis was scored from grade 0 to 2 on the MRI-MIP images. The Sharp/van der Heijde score and Larsen grade were used for radiographic evaluation. The relationships between the MIP score and the progression of radiographic scores and between the MIP score and bone marrow edema on MRI were analyzed using the trend test. As the MIP score increased, the Sharp/van der Heijde score and Larsen grade progressed severely. The rate of bone marrow edema-positive joints also increased with higher MIP scores. MRI-MIP imaging of RA hands is a clinically useful method that allows semi-quantitative evaluation of synovitis with ease and can be used to predict joint destruction. |
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