The role of dynamic contrast-enhanced MRI in the differential diagnosis of psoriatic and rheumatoid arthritis

Nina F. Schwenzer, Ina Kötter, Jörg C. Henes, Christina Schraml, Jan Fritz, Claus D. Claussen, Marius Horger

Research output: Contribution to journalArticle

Abstract

OBJECTIVE. The purpose of this study was to investigate the role of dynamic contrastenhanced MRI in the differential diagnosis of psoriatic and rheumatoid arthritis in the hand and wrist. SUBJECTS AND METHODS. Forty-five consecutive patients (31 patients with rheumatoid arthritis and 14 patients with psoriatic arthritis) were examined in a 3-T whole-body MR unit. After contrast injection, a 3D encoded spoiled gradient-echo sequence was used for measurement of the time course of contrast-medium uptake in the synovial tissue. On the basis of the gained uptake curves, the rate of early enhancement was calculated after 35 and 52 seconds, and the relative enhancement rate was calculated after 35 seconds, 52 seconds, 3 minutes, and 15 minutes (late enhancement). Dynamic contrast-enhanced MRI rates of patients with rheumatoid arthritis and psoriatic arthritis were compared and correlated with laboratory and clinical data. RESULTS. A statistically significant difference between the two groups was found regarding the relative enhancement rate after 15 minutes (p <0.01). In contrast, no difference in relative enhancement rate was found 35 seconds, 52 seconds, or 3 minutes after contrast injection (p = 0.695, p = 0.573, and p = 0.278, respectively). Regarding the rate of early enhancement at 35 and 52 seconds, no significant difference between patients with rheumatoid arthritis and those with psoriatic arthritis was found. Significant correlations were found between inflammatory parameters and dynamic contrast-enhanced parameters in patients with rheumatoid arthritis but not in those with psoriatic arthritis. CONCLUSION. Fifteen minutes after contrast injection, a statistically significant difference between rheumatoid arthritis and psoriatic arthritis was found in synovial enhancement that might play an important role in differentiating the two diseases.

Original languageEnglish (US)
Pages (from-to)715-720
Number of pages6
JournalAmerican Journal of Roentgenology
Volume194
Issue number3
DOIs
StatePublished - Mar 2010
Externally publishedYes

Fingerprint

Psoriatic Arthritis
Rheumatoid Arthritis
Differential Diagnosis
Injections
Wrist
Contrast Media
Hand

Keywords

  • DCE-MRI
  • Dynamic contrast-enhanced MRI
  • Psoriatic arthritis
  • RA
  • Rheumatoid arthritis

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

Cite this

The role of dynamic contrast-enhanced MRI in the differential diagnosis of psoriatic and rheumatoid arthritis. / Schwenzer, Nina F.; Kötter, Ina; Henes, Jörg C.; Schraml, Christina; Fritz, Jan; Claussen, Claus D.; Horger, Marius.

In: American Journal of Roentgenology, Vol. 194, No. 3, 03.2010, p. 715-720.

Research output: Contribution to journalArticle

Schwenzer, Nina F. ; Kötter, Ina ; Henes, Jörg C. ; Schraml, Christina ; Fritz, Jan ; Claussen, Claus D. ; Horger, Marius. / The role of dynamic contrast-enhanced MRI in the differential diagnosis of psoriatic and rheumatoid arthritis. In: American Journal of Roentgenology. 2010 ; Vol. 194, No. 3. pp. 715-720.
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abstract = "OBJECTIVE. The purpose of this study was to investigate the role of dynamic contrastenhanced MRI in the differential diagnosis of psoriatic and rheumatoid arthritis in the hand and wrist. SUBJECTS AND METHODS. Forty-five consecutive patients (31 patients with rheumatoid arthritis and 14 patients with psoriatic arthritis) were examined in a 3-T whole-body MR unit. After contrast injection, a 3D encoded spoiled gradient-echo sequence was used for measurement of the time course of contrast-medium uptake in the synovial tissue. On the basis of the gained uptake curves, the rate of early enhancement was calculated after 35 and 52 seconds, and the relative enhancement rate was calculated after 35 seconds, 52 seconds, 3 minutes, and 15 minutes (late enhancement). Dynamic contrast-enhanced MRI rates of patients with rheumatoid arthritis and psoriatic arthritis were compared and correlated with laboratory and clinical data. RESULTS. A statistically significant difference between the two groups was found regarding the relative enhancement rate after 15 minutes (p <0.01). In contrast, no difference in relative enhancement rate was found 35 seconds, 52 seconds, or 3 minutes after contrast injection (p = 0.695, p = 0.573, and p = 0.278, respectively). Regarding the rate of early enhancement at 35 and 52 seconds, no significant difference between patients with rheumatoid arthritis and those with psoriatic arthritis was found. Significant correlations were found between inflammatory parameters and dynamic contrast-enhanced parameters in patients with rheumatoid arthritis but not in those with psoriatic arthritis. CONCLUSION. Fifteen minutes after contrast injection, a statistically significant difference between rheumatoid arthritis and psoriatic arthritis was found in synovial enhancement that might play an important role in differentiating the two diseases.",
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AB - OBJECTIVE. The purpose of this study was to investigate the role of dynamic contrastenhanced MRI in the differential diagnosis of psoriatic and rheumatoid arthritis in the hand and wrist. SUBJECTS AND METHODS. Forty-five consecutive patients (31 patients with rheumatoid arthritis and 14 patients with psoriatic arthritis) were examined in a 3-T whole-body MR unit. After contrast injection, a 3D encoded spoiled gradient-echo sequence was used for measurement of the time course of contrast-medium uptake in the synovial tissue. On the basis of the gained uptake curves, the rate of early enhancement was calculated after 35 and 52 seconds, and the relative enhancement rate was calculated after 35 seconds, 52 seconds, 3 minutes, and 15 minutes (late enhancement). Dynamic contrast-enhanced MRI rates of patients with rheumatoid arthritis and psoriatic arthritis were compared and correlated with laboratory and clinical data. RESULTS. A statistically significant difference between the two groups was found regarding the relative enhancement rate after 15 minutes (p <0.01). In contrast, no difference in relative enhancement rate was found 35 seconds, 52 seconds, or 3 minutes after contrast injection (p = 0.695, p = 0.573, and p = 0.278, respectively). Regarding the rate of early enhancement at 35 and 52 seconds, no significant difference between patients with rheumatoid arthritis and those with psoriatic arthritis was found. Significant correlations were found between inflammatory parameters and dynamic contrast-enhanced parameters in patients with rheumatoid arthritis but not in those with psoriatic arthritis. CONCLUSION. Fifteen minutes after contrast injection, a statistically significant difference between rheumatoid arthritis and psoriatic arthritis was found in synovial enhancement that might play an important role in differentiating the two diseases.

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