OBJECTIVES: To assess the diagnostic accuracy and reliability of MRI without contrast enhancement in the evaluation of JIA knee joint abnormalities. METHODS: JIA patients with clinically active knee involvement were prospectively studied using an 1-T open-bore magnet. MRI features were independently evaluated by two readers using the JAMRIS system. The first reading included unenhanced images, whereas complete image sets were available for the second reading. RESULTS: Imaging findings from 73 patients were analysed. Agreement between Gd-enhanced (+Gd) and Gd-unenhanced (-Gd) MRI scores of bone marrow changes, cartilage lesions and bone erosions was good concerning sensitivity, specificity, negative predictive value and positive predictive value. Inter-observer agreement was good for both -Gd and +Gd scores (ICC = 0.91-1.00, 0.93-1.00, respectively). Regarding the assessment of synovial hypertrophy, specificity of -Gd was high (0.97), but the sensitivity of unenhanced MRI was only 0.62. Inter-reader agreement for +Gd MRI was ICC = 0.94; however, omitting post-Gd acquisitions increased inter-reader variation (ICC = 0.86). CONCLUSIONS: If Gd-enhanced MRI is the reference standard, omitting Gd contrast medium is irrelevant for the assessment of bone marrow changes, cartilage lesions and bone erosions as joint abnormalities in JIA. Omitting intravenous Gd in the MRI assessment of joints in JIA is inadvisable, because it decreases the reliability of detecting synovial disease. KEY POINTS: • Magnetic resonance imaging is increasingly used to assess juvenile idiopathic arthritis. • Synovial hypertrophy, a marker of JIA activity, is well shown by MRI. • Omitting intravenous contrast medium decreases the reliability of synovial hypertrophy scores. • Bone marrow, cartilage and erosions can be reliably evaluated without contrast enhancement. • In the evaluation of JIA disease activity, unenhanced MRI is inadvisable.
OBJECTIVES: To assess the diagnostic accuracy and reliability of MRI without contrast enhancement in the evaluation of JIA knee joint abnormalities. METHODS: JIA patients with clinically active knee involvement were prospectively studied using an 1-T open-bore magnet. MRI features were independently evaluated by two readers using the JAMRIS system. The first reading included unenhanced images, whereas complete image sets were available for the second reading. RESULTS: Imaging findings from 73 patients were analysed. Agreement between Gd-enhanced (+Gd) and Gd-unenhanced (-Gd) MRI scores of bone marrow changes, cartilage lesions and bone erosions was good concerning sensitivity, specificity, negative predictive value and positive predictive value. Inter-observer agreement was good for both -Gd and +Gd scores (ICC = 0.91-1.00, 0.93-1.00, respectively). Regarding the assessment of synovial hypertrophy, specificity of -Gd was high (0.97), but the sensitivity of unenhanced MRI was only 0.62. Inter-reader agreement for +Gd MRI was ICC = 0.94; however, omitting post-Gd acquisitions increased inter-reader variation (ICC = 0.86). CONCLUSIONS: If Gd-enhanced MRI is the reference standard, omitting Gd contrast medium is irrelevant for the assessment of bone marrow changes, cartilage lesions and bone erosions as joint abnormalities in JIA. Omitting intravenous Gd in the MRI assessment of joints in JIA is inadvisable, because it decreases the reliability of detecting synovial disease. KEY POINTS: • Magnetic resonance imaging is increasingly used to assess juvenile idiopathic arthritis. • Synovial hypertrophy, a marker of JIA activity, is well shown by MRI. • Omitting intravenous contrast medium decreases the reliability of synovial hypertrophy scores. • Bone marrow, cartilage and erosions can be reliably evaluated without contrast enhancement. • In the evaluation of JIA disease activity, unenhanced MRI is inadvisable.
Authors: V M Gylys-Morin; T B Graham; J S Blebea; B J Dardzinski; T Laor; N D Johnson; A E Oestreich; M H Passo Journal: Radiology Date: 2001-09 Impact factor: 11.105
Authors: A K Brown; M A Quinn; Z Karim; P G Conaghan; C G Peterfy; E Hensor; R J Wakefield; P J O'Connor; P Emery Journal: Arthritis Rheum Date: 2006-12
Authors: H M Albers; J A M Wessels; R J H M van der Straaten; D M C Brinkman; L W A Suijlekom-Smit; S S M Kamphuis; H J Girschick; C Wouters; M W Schilham; S le Cessie; T W J Huizinga; R Ten Cate; H J Guchelaar Journal: Arthritis Rheum Date: 2009-01-15
Authors: Wouter Stomp; Annemarie Krabben; Désirée van der Heijde; Tom W J Huizinga; Johan L Bloem; Mikkel Østergaard; Annette H M van der Helm-van Mil; Monique Reijnierse Journal: Eur Radiol Date: 2015-01-31 Impact factor: 5.315
Authors: Floris Verkuil; Robert Hemke; E Charlotte van Gulik; Anouk M Barendregt; Amara Nassar-Sheikh Rashid; Dieneke Schonenberg-Meinema; Koert M Dolman; Eline E Deurloo; Kees F van Dijke; J Michiel den Harder; Taco W Kuijpers; J Merlijn van den Berg; Mario Maas Journal: Insights Imaging Date: 2022-10-20
Authors: Robert Hemke; Cristina Lavini; Charlotte M Nusman; J Merlijn van den Berg; Koert M Dolman; Dieneke Schonenberg-Meinema; Marion A J van Rossum; Taco W Kuijpers; Mario Maas Journal: Eur Radiol Date: 2014-04-26 Impact factor: 5.315
Authors: Anouk M Barendregt; E Charlotte van Gulik; Paul F C Groot; Koert M Dolman; J Merlijn van den Berg; Amara Nassar-Sheikh Rashid; Dieneke Schonenberg-Meinema; Cristina Lavini; Karen Rosendahl; Robert Hemke; Taco W Kuijpers; Mario Maas; Charlotte M Nusman Journal: Pediatr Radiol Date: 2019-02-01
Authors: Robert Hemke; Mario Maas; Mira van Veenendaal; Koert M Dolman; Marion A J van Rossum; J Merlijn van den Berg; Taco W Kuijpers Journal: Eur Radiol Date: 2013-10-08 Impact factor: 5.315