A simplified fluid-sensitive MRI protocol for the hands to detect inflammation without contrast administration: a large study of symptom-free subjects from the general population as a reference for normality.

Autor: Boeren AMP; Department of Rheumatology, Erasmus Medical Centre, Rotterdam, The Netherlands. a.boeren@erasmusmc.nl.; Department of Rheumatology, Leiden University Medical Centre, Leiden, The Netherlands. a.boeren@erasmusmc.nl., Ton DA; Department of Rheumatology, Leiden University Medical Centre, Leiden, The Netherlands., van Mulligen E; Department of Rheumatology, Erasmus Medical Centre, Rotterdam, The Netherlands.; Department of Rheumatology, Leiden University Medical Centre, Leiden, The Netherlands., Klerk BB; Department of Rheumatology, Leiden University Medical Centre, Leiden, The Netherlands.; Department of Clinical Epidemiology, Leiden University Medical Centre, Rotterdam, The Netherlands., de Jong PHP; Department of Rheumatology, Erasmus Medical Centre, Rotterdam, The Netherlands., Oei EHG; Department of Radiology & Nuclear Medicine, Erasmus Medical Centre, Rotterdam, The Netherlands., Reijnierse M; Department of Radiology, Leiden University Medical Centre, Rotterdam, The Netherlands., van der Helm-van Mil AHM; Department of Rheumatology, Erasmus Medical Centre, Rotterdam, The Netherlands.; Department of Rheumatology, Leiden University Medical Centre, Leiden, The Netherlands.
Jazyk: angličtina
Zdroj: Skeletal radiology [Skeletal Radiol] 2024 Dec 09. Date of Electronic Publication: 2024 Dec 09.
DOI: 10.1007/s00256-024-04843-9
Abstrakt: Objective: MRI of the hands is valuable for risk-stratification in patients with arthralgia at-risk for developing rheumatoid arthritis (RA). Contrast-enhanced MRI is considered standard for assessment of RA, but has practical disadvantages. It also shows inflammation-like features in the general population, especially at older age, which should be considered in image interpretation. The modified-Dixon (mDixon) technique is reliable compared to contrast-enhanced sequences. Moreover, this short protocol without contrast-enhancement is patient-friendly. Whether it also shows inflammation-like features in the general population is unknown. We studied this to support accurate use in the clinic.
Methods: Two hundred twenty symptom-free volunteers from different age-categories were recruited from the general population and underwent mDixon MRI of both hands. Two readers independently scored MRIs for synovitis, tenosynovitis, and bone marrow edema (BME) in the metacarpophalangeal-joints (MCP) and wrists according to the RAMRIS. Features were considered present if scored by both readers; frequencies > 5% were considered relevant in terms of specificity and determined per age-category (< 40/40- < 60/ ≥ 60-years).
Results: Higher age correlated with higher BME-scores (p-value < 0.005), but not with synovitis and tenosynovitis-scores. BME (grade 1) occurred in some bones in people aged ≥ 60, 14% had BME in the lunate, 7% in metacarpal-1, and 6% in the trapezium. Synovitis and tenosynovitis did not occur in > 5%, except for grade-1 synovitis in the right distal radio-ulnar-joint in people aged ≥ 60 (11%).
Conclusion: On mDixon MRI, inflammatory features in the hands of the general population are rare. This facilitates image interpretation. To prevent overinterpretation, only several locations should be considered when evaluating people aged ≥ 60-years.
Competing Interests: Declarations. Ethics approval: The study was conducted in compliance with the Helsinki Declaration. Written informed consent was obtained from all participants included in the study. The research protocol for the Rotterdam CSA-cohort (MEC-2017–028) was approved by the local Medical Ethical Committee of the Erasmus Medical Center (EMC). Competing interests: The authors declare no competing interests.
(© 2024. The Author(s).)
Databáze: MEDLINE
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