scholarly journals Reasons for discordances between ultrasonography and magnetic resonance imaging in the evaluation of the ankle, hindfoot and heel of the patients with rheumatoid arthritis

2019 ◽  
Vol 21 (4) ◽  
pp. 405 ◽  
Author(s):  
Oana Șerban ◽  
Daniela Fodor ◽  
Iulia Papp ◽  
Mihaela Cosmina Micu ◽  
Dan Gabriel Duma ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Disease Activity ◽  
Activity Index ◽  
Imaging Techniques ◽  
Disease Activity Index ◽  
Resonance Imaging ◽  
Magnetic Resonance Imaging Mri ◽  
Definition Of

Aim: To compare the ultrasonography (US) performance with magnetic resonance imaging (MRI) in identifying pathology in ankles, hindfeet and heels of rheumatoid arthritis (RA) patients and to evaluate the reasons for discordances between the two imaging methods.Material and methods: RA patients were enrolled and evaluated using the Clinical Disease Activity Index (CDAI) and the Disease Activity Score 28 with C-reactive Protein (DAS28-CRP). The ankle (tibiotalar joint, tendons), hindfoot (talonavicular, subtalar joints) and heel of the most symptomatic or dominant foot (for the asymptomatic patient)were evaluated by two pairs of examiners using US and contrast-enhanced MRI.Results: Totally, 105 joints, 245 tendons and 35 heels in 35 patients [mean age 59.2±11.25 years old, median disease duration 36 (16.5-114), mean CDAI 19.87±12.7] were evaluated. The interobserver agreements between the two sonographers, and the two radiologists were good and very good (k=0.624-0.940). The overall agreement between US and MRI was very good for subcalcaneal panniculitis (k=0.928, p<0.001), moderate for synovitis (k=0.463, p<0.001) and tenosynovitis (k=0.514, p<0.001), fair for osteophytes (k=0.260, p=0.004), and poor for erosions (k=0.063, p=0.308) and heel’s structures. MRI found more erosions, synovitis, osteophytes,tenosynovitis and retrocalcaneal bursitis, but US found more enthesophytes and plantar fasciitis. Many of the discordancesbetween the two imaging techniques have explanations related to the technique itself or definition of the pathologic findings.Conclusions: US is comparable to MRI for the evaluation of ankle, hindfoot and heel in RA patients and discordances in theinterpretation of the pathological findings/normal structures must be carefully analyzed.

Short-term changes in magnetic resonance imaging and disease activity in response to infliximab

2009 ◽  
Vol 69 (01) ◽  
pp. 120-125 ◽  
Author(s):  
H M Bonel ◽  
C Boller ◽  
B Saar ◽  
S Tanner ◽  
S Srivastav ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Disease Activity ◽  
Activity Index ◽  
Disease Activity Index ◽  
Term Treatment ◽  
Local Inflammation ◽  
Resonance Imaging ◽  
Short Term ◽  
Long Term Treatment

Objectives:To characterise and quantify short-term changes in local inflammation using magnetic resonance imaging (MRI), and to correlate the findings with clinical disease activity in response to infliximab in patients with spondyloarthritis.Methods:28 consecutive patients with established spondyloarthritis under successful long-term treatment with infliximab underwent MRI immediately before and one week after re-administration of the TNF blocker. C-reactive protein and the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) were assessed at both time points. The MRI protocol included coronal and sagittal turbo-short T1 inversion recovery (STIR) images as well as contrast-enhanced sagittal T1-weighted, fat-suppressed images. Images were assessed in independent sessions using the ASspiMRI-a score, the signal-difference-to-noise ratios (SDNR) and volumetry to assess oedematous and inflamed tissues.Results:BASDAI values were expectedly low at study entry (3.3, SD 2.3). One week after administration of infliximab, 46% of patients reached a BASDAI 20, 39% a BASDAI 50. Kappa values for qualitative assessments and all measurements were excellent (range between 0.83 and 1.0) The ASspiMRI-a dropped most in the thoracic (3.3 points), less in the lumbar (1.21 points) and least in the cervical spine (0.38 points). The decrease of the ASspiMRI-a, the SDNR and the inflamed volumes in response to infliximab re-treatment was significant (p<0.01). The BASDAI showed a weak correlation with the ASspiMRI-a (r  =  0.41).Conclusions:MRI proves to be a valid method to assess and quantify short-term effects of therapy in spondyloarthritis. Comparison between MRI and BASDAI changes show that the BASDAI may underestimate local inflammation. It suggests an explanation for the structural disease progression despite clinical remission.

scholarly journals Magnetic Resonance Imaging (MRI) Results Following Discontinuation of Methotrexate in Rheumatoid Arthritis Treated with Subcutaneous Tocilizumab: The COMP-ACT MRI Substudy

2019 ◽  
Vol 47 (3) ◽  
pp. 325-332
Author(s):  
Charles Peterfy ◽  
Joel Kremer ◽  
William Rigby ◽  
Nora Singer ◽  
Christine Birchwood ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Disease Activity ◽  
Joint Damage ◽  
Cartilage Loss ◽  
Resonance Imaging ◽  
Low Disease Activity ◽  
Magnetic Resonance Imaging Mri ◽  
And Cartilage

Objective.To assess differences in joint damage and inflammation using magnetic resonance imaging (MRI) between patients with rheumatoid arthritis (RA) who achieved low disease activity with tocilizumab (TCZ) + methotrexate (MTX) and subsequently continued or discontinued MTX.Methods.In the COMP-ACT trial, US patients with RA received subcutaneous TCZ 162 mg + MTX. Those who achieved 28-joint count Disease Activity Score calculated with erythrocyte sedimentation rate (DAS28-ESR) ≤ 3.2 at Week 24 were randomized 1:1 (double-blind) to discontinue MTX (TCZ monotherapy; mono) or continue TCZ + MTX until Week 52. In a subset of patients, 1.5-Tesla MRI was used to obtain images of bilateral hands and wrists at weeks 24 and 40. Outcomes included changes in MRI-assessed synovitis, osteitis, erosion, and cartilage loss from Week 24 to Week 40, and in the proportion of patients with progression of each score.Results.Of 296 patients who achieved DAS28-ESR ≤ 3.2 at Week 24, 79 were enrolled in the pilot MRI substudy and randomized to TCZ mono (n = 38) or TCZ + MTX (n = 41). Treatment with either TCZ mono or TCZ + MTX suppressed erosion progression, synovitis, osteitis, and cartilage loss. The proportion of patients with no progression in each outcome measure was similar between groups (range, TCZ mono: 84.8–97.0%; TCZ + MTX: 92.3–100%).Conclusion.In a subset of patients who achieved low disease activity with TCZ + MTX, MRI changes were minimal in intraarticular inflammation and damage measures in patients who discontinued MTX versus those who continued TCZ + MTX.

ACR/EULAR Definitions of Remission Are Associated with Lower Residual Inflammatory Activity Compared with DAS28 Remission on Hand MRI in Rheumatoid Arthritis

2016 ◽  
Vol 43 (9) ◽  
pp. 1631-1636 ◽  
Author(s):  
Maria Pilar Lisbona ◽  
Albert Solano ◽  
Jesús Ares ◽  
Miriam Almirall ◽  
Tarek Carlos Salman-Monte ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Disease Activity ◽  
Activity Index ◽  
Calculated Data ◽  
Inflammatory Lesion ◽  
Resonance Imaging ◽  
Characteristic Analysis ◽  
Cross Sectional

Objective.To determine the level of residual inflammation [synovitis, bone marrow edema (BME), tenosynovitis, and total inflammation] quantified by hand magnetic resonance imaging (h-MRI) in patients with rheumatoid arthritis (RA) in remission according to 3 different definitions of clinical remission, and to compare these remission definitions.Methods.A cross-sectional study. To assess the level of residual MRI inflammation in remission, cutoff levels associated to remission and median scores of MRI residual inflammatory lesions were calculated. Data from an MRI register of patients with RA who have various levels of disease activity were used. These were used for the analyses: synovitis, BME according to the Rheumatoid Arthritis Magnetic Resonance Imaging Scoring system, tenosynovitis, total inflammation, and disease activity composite measures recorded at the time of MRI. Receiver-operating characteristic analysis was used to identify the best cutoffs associated with remission for each inflammatory lesion on h-MRI. Median values of each inflammatory lesion for each definition of remission were also calculated.Results.A total of 388 h-MRI sets of patients with RA with different levels of disease activity, 130 in remission, were included. Cutoff values associated with remission according to the Simplified Disease Activity Index (SDAI) ≤ 3.3 and the Boolean American College of Rheumatology/European League Against Rheumatism (ACR/EULAR) definitions for BME and tenosynovitis (1 and 3, respectively) were lower than BME and tenosynovitis (2 and 5, respectively) for the Disease Activity Score on 28 joints (DAS28) ≤ 2.6. Median scores for synovitis, BME, and total inflammation were also lower for the SDAI and Boolean ACR/EULAR remission criteria compared with DAS28.Conclusion.Patients with RA in remission according to the SDAI and Boolean ACR/EULAR definitions showed lower levels of MRI-detected residual inflammation compared with DAS28.

scholarly journals The OMERACT Rheumatoid Arthritis Magnetic Resonance Imaging (MRI) Scoring System: Updated Recommendations by the OMERACT MRI in Arthritis Working Group

2017 ◽  
Vol 44 (11) ◽  
pp. 1706-1712 ◽  
Author(s):  
Mikkel Østergaard ◽  
Charles G. Peterfy ◽  
Paul Bird ◽  
Frédérique Gandjbakhch ◽  
Daniel Glinatsi ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Working Group ◽  
Scoring System ◽  
Research Agenda ◽  
Image Resolution ◽  
Sensitivity To Change ◽  
Resonance Imaging ◽  
Magnetic Resonance Imaging Mri

Objective.The Outcome Measures in Rheumatology (OMERACT) Rheumatoid Arthritis (RA) Magnetic Resonance Imaging (MRI) scoring system (RAMRIS), evaluating bone erosion, bone marrow edema/osteitis, and synovitis, was introduced in 2002, and is now the standard method of objectively quantifying inflammation and damage by MRI in RA trials. The objective of this paper was to identify subsequent advances and based on them, to provide updated recommendations for the RAMRIS.Methods.MRI studies relevant for RAMRIS and technical and scientific advances were analyzed by the OMERACT MRI in Arthritis Working Group, which used these data to provide updated considerations on image acquisition, RAMRIS definitions, and scoring systems for the original and new RA pathologies. Further, a research agenda was outlined.Results.Since 2002, longitudinal studies and clinical trials have documented RAMRIS variables to have face, construct, and criterion validity; high reliability and sensitivity to change; and the ability to discriminate between therapies. This has enabled RAMRIS to demonstrate inhibition of structural damage progression with fewer patients and shorter followup times than has been possible with conventional radiography. Technical improvements, including higher field strengths and improved pulse sequences, allow higher image resolution and contrast-to-noise ratio. These have facilitated development and validation of scoring methods of new pathologies: joint space narrowing and tenosynovitis. These have high reproducibility and moderate sensitivity to change, and can be added to RAMRIS. Combined scores of inflammation or joint damage may increase sensitivity to change and discriminative power. However, this requires further research.Conclusion.Updated 2016 RAMRIS recommendations and a research agenda were developed.

scholarly journals Perfusion Magnetic Resonance Imaging to Assess Brain Tumor Responses to New Therapies

1998 ◽  
Vol 5 (2) ◽  
pp. 115-123 ◽  
Author(s):  
Michael H. Lev ◽  
Fred Hochberg
Keyword(s):  
Magnetic Resonance Imaging ◽  
Brain Tumor ◽  
Magnetic Resonance ◽  
Imaging Techniques ◽  
Perfusion Mri ◽  
Perfusion Magnetic Resonance Imaging ◽  
Normal Brain ◽  
Resonance Imaging ◽  
New Therapies ◽  
Magnetic Resonance Imaging Mri

Background: Although magnetic resonance imaging (MRI) is effective in detecting the location of intracranial tumors, new imaging techniques have been studied that may enhance the specificity for the prediction of histologic grade of tumor and for the distinction between recurrence and tumor necrosis associated with cancer therapy. Methods: The authors review their experience and that of others on the use of perfusion magnetic resonance imaging to evaluate responses of brain tumors to new therapies. Results: Functional imaging techniques that can distinguish tumor from normal brain tissue using physiological parameters. These new approaches provide maps of tumor perfusion to monitor the effects of novel compounds that restrict tumor angiogenesis. Conclusions: Perfusion MRI not only may be as effective as radionuclide-based techniques in sensitivity and specificity in assessing brain tumor responses to new therapies, but also may offer higher resolution and convenient co-registration with conventional MRI, as well as time- and cost-effectiveness. Further study is needed to determine the role of perfusion MRI in assessing brain tumor responses to new therapies.

scholarly journals Magnetic resonance imaging of salivary glands

2019 ◽  
Author(s):  
Danielle Ayumi Nishimura ◽  
Ana Luiza Esteves Carneiro ◽  
Kaisermann Costa ◽  
Wladimir Gushiken de Campos ◽  
Jefferson Xavier de Oliveira ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Salivary Glands ◽  
Imaging Techniques ◽  
Neck Region ◽  
Evaluation Instrument ◽  
Resonance Imaging ◽  
Tissue Contrast ◽  
Excellent Method ◽  
Magnetic Resonance Imaging Mri

Salivary glands tumors account for 2-5% of tumors in the head and neck region, possibly being benign or malignant. Magnetic resonance imaging (MRI) presents high soft tissue contrast resolution, thus being an excellent method for salivary gland analysis. The objective of this literature review is to analyze MRI as an evaluation instrument for the diagnosis of salivary glands lesions. Compared to other imaging techniques, MRI can better evaluate the relationship between adjacent anatomical structures, presenting greater sensitivity and specificity.

Magnetic Resonance Imaging of the Rheumatic Foot According to the RAMRIS System Is Reliable

2011 ◽  
Vol 38 (6) ◽  
pp. 1003-1008 ◽  
Author(s):  
HENRIËTTE BAAN ◽  
ROLAND BEZOOIJEN ◽  
JOHANNES K.A. AVENARIUS ◽  
ROSEMARY DUBBELDAM ◽  
WIEPKE K. DROSSAERS-BAKKER ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Scoring System ◽  
Bone Erosion ◽  
Outcome Measurement ◽  
Random Sets ◽  
Resonance Imaging ◽  
Bone Edema ◽  
Magnetic Resonance Imaging Mri

Objective.In rheumatology, magnetic resonance imaging (MRI) is predominantly applied in the assessment and outcome measurement of rheumatoid arthritis (RA) in hands and wrists, leading to the development of the RAMRIS (RA-MRI-Scoring) system. It was initiated by the Outcome Measures in Rheumatoid Arthritis Clinical Trials (OMERACT). The RAMRIS system has not been applied widely in the measurement of feet. We investigated the interreader and intrareader agreement of the RAMRIS scoring system in the assessment of feet in RA.Methods.Twenty-nine patients with RA who had radiological damage and/or arthritis underwent MRI. Two experienced readers independently read both complete sets. One reader read 6 random sets after the initial session, in order to assess the intrareader agreement. For evaluation of the intrareader and interreader reliability, quadratic-weighted κ scores were calculated per joint and lesion.Results.For the forefeet, interreader scores were excellent, ranging from 0.77 (bone edema) to 0.95 (bone erosion). Hindfoot interreader agreement scores were highest for erosion (0.90) and synovitis global score (0.88), but edema and synovial thickness agreement were also acceptable (0.83 and 0.86). Intrareader scores were on the whole slightly lower, but excellent.Conclusion.Reliability (interreader and intrareader agreement) in the assessment of the rheumatoid foot according to the RAMRIS method is excellent.

Sign in / Sign up

Export Citation Format

Share Document