N. Nakahara et al., GADOLINIUM-ENHANCED MR-IMAGING OF THE WRIST IN RHEUMATOID-ARTHRITIS -VALUE OF FAT-SUPPRESSION PULSE SEQUENCES, Skeletal radiology, 25(7), 1996, pp. 639-647
Objective. To determine the usefulness of fat-suppressed gadolinium (G
d)-enhanced MR imaging of the wrist in patients with rheumatoid arthri
tis (RA). Design and patients. Fat-suppressed Gd-enhanced T1-weighted
spin-echo (SE) images were obtained and compared with other standard t
echniques in 38 wrists of 27 patients (22-77 years) with RA. Scoring b
ased on the degree of synovial enhancement of each joint was developed
and the total scores (J-score) were correlated with radiographic stag
e, C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), and
symptomatic change in the follow-up study. Results. Synovial prolifer
ations showed marked enhancement in all the wrists. In addition, contr
ast enhancement in the bone marrow and tenosynovium was seen in 36 and
eight wrists respectively. Fat-suppressed Gd-enhanced T1-weighted ima
ges demonstrated these abnormalities better than other techniques, The
J-scores correlated well with values of CRP (P=0.0034), but not with
radiographic stages and ESR. Conclusion. Fat-suppressed Gd-enhanced T1
-weighted SE images can clearly demonstrate most of the essential lesi
ons in RA including the proliferative synovium, bone erosion, bone mar
row inflammatory change, and tenosynovitis. Scoring based on the exten
t of Gd-enhancement of synovium can be useful in the assessment of the
inflammatory status.