B J E de Lange-Brokaar1, A Ioan-Facsinay2, E Yusuf3, A W Visser4, H M Kroon5, S N Andersen6, L Herb-van Toorn7, G J V M van Osch8, A-M Zuurmond9, V Stojanovic-Susulic10, J L Bloem11, R G H H Nelissen12, T W J Huizinga13, M Kloppenburg14. 1. Department of Rheumatology, Leiden University Medical Center, Leiden, The Netherlands. Electronic address: b.j.e.de_lange@lumc.nl. 2. Department of Rheumatology, Leiden University Medical Center, Leiden, The Netherlands. Electronic address: A.Ioan@lumc.nl. 3. Department of Rheumatology, Leiden University Medical Center, Leiden, The Netherlands. Electronic address: E.Yusuf@lumc.nl. 4. Department of Rheumatology, Leiden University Medical Center, Leiden, The Netherlands. Electronic address: A.W.Visser@lumc.nl. 5. Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands. Electronic address: H.M.J.A.Kroon@lumc.nl. 6. Department of Rheumatology, Leiden University Medical Center, Leiden, The Netherlands. Electronic address: S.N.Andersen@lumc.nl. 7. Department of Rheumatology, Leiden University Medical Center, Leiden, The Netherlands. Electronic address: L.van_Toorn@lumc.nl. 8. Department of Orthopaedics and Otorhinolarynogology, Erasmus MC, University Medical Center, Rotterdam, The Netherlands. Electronic address: g.vanosch@erasmusmc.nl. 9. TNO, Leiden, The Netherlands. Electronic address: anne-marie.zuurmond@tno.nl. 10. Janssen Research & Development, LLC, Spring House, PA, USA. Electronic address: VStojano@its.jnj.com. 11. Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands. Electronic address: J.L.Bloem@lumc.nl. 12. Department Orthopaedics, Leiden University Medical Center, Leiden, The Netherlands. Electronic address: R.G.H.H.Nelissen@lumc.nl. 13. Department of Rheumatology, Leiden University Medical Center, Leiden, The Netherlands. Electronic address: T.W.J.Huizinga@lumc.nl. 14. Department of Rheumatology, Leiden University Medical Center, Leiden, The Netherlands; Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, The Netherlands. Electronic address: G.Kloppenburg@lumc.nl.
Abstract
OBJECTIVE: To evaluate the association between synovitis on contrast enhanced (CE) MRI with microscopic and macroscopic features of synovial tissue inflammation. METHOD: Forty-one patients (mean age 60 years, 61% women) with symptomatic radiographic knee OA were studied: twenty underwent arthroscopy (macroscopic features were scored (0-4), synovial biopsies obtained), twenty-one underwent arthroplasty (synovial tissues were collected). After haematoxylin and eosin staining, the lining cell layer, synovial stroma and inflammatory infiltrate of synovial tissues were scored (0-3). T1-weighted CE-MRI's (3 T) were used to semi-quantitatively score synovitis at 11 sites (0-22) according to Guermazi et al. Spearman's rank correlations were calculated. RESULTS: The mean (SD) MRI synovitis score was 8.0 (3.7) and the total histology grade was 2.5 (1.6). Median (range) scores of macroscopic features were 2 (1-3) for neovascularization, 1 (0-3) for hyperplasia, 2 (0-4) for villi and 2 (0-3) for fibrin deposits. The MRI synovitis score was significantly correlated with total histology grade [r = 0.6], as well as with lining cell layer [r = 0.4], stroma [r = 0.3] and inflammatory infiltrate [r = 0.5] grades. Moreover, MRI synovitis score was also significantly correlated with macroscopic neovascularization [r = 0.6], hyperplasia [r = 0.6] and villi [r = 0.6], but not with fibrin [r = 0.3]. CONCLUSION: Synovitis severity on CE-MRI assessed by a new whole knee scoring system by Guermazi et al. is a valid, non-invasive method to determine synovitis as it is significantly correlated with both macroscopic and microscopic features of synovitis in knee OA patients.
OBJECTIVE: To evaluate the association between synovitis on contrast enhanced (CE) MRI with microscopic and macroscopic features of synovial tissue inflammation. METHOD: Forty-one patients (mean age 60 years, 61% women) with symptomatic radiographic knee OA were studied: twenty underwent arthroscopy (macroscopic features were scored (0-4), synovial biopsies obtained), twenty-one underwent arthroplasty (synovial tissues were collected). After haematoxylin and eosin staining, the lining cell layer, synovial stroma and inflammatory infiltrate of synovial tissues were scored (0-3). T1-weighted CE-MRI's (3 T) were used to semi-quantitatively score synovitis at 11 sites (0-22) according to Guermazi et al. Spearman's rank correlations were calculated. RESULTS: The mean (SD) MRI synovitis score was 8.0 (3.7) and the total histology grade was 2.5 (1.6). Median (range) scores of macroscopic features were 2 (1-3) for neovascularization, 1 (0-3) for hyperplasia, 2 (0-4) for villi and 2 (0-3) for fibrin deposits. The MRI synovitis score was significantly correlated with total histology grade [r = 0.6], as well as with lining cell layer [r = 0.4], stroma [r = 0.3] and inflammatory infiltrate [r = 0.5] grades. Moreover, MRI synovitis score was also significantly correlated with macroscopic neovascularization [r = 0.6], hyperplasia [r = 0.6] and villi [r = 0.6], but not with fibrin [r = 0.3]. CONCLUSION:Synovitis severity on CE-MRI assessed by a new whole knee scoring system by Guermazi et al. is a valid, non-invasive method to determine synovitis as it is significantly correlated with both macroscopic and microscopic features of synovitis in knee OA patients.
Authors: Dominic T Mathis; Anna Hirschmann; Anna L Falkowski; Tommi Kiekara; Felix Amsler; Helmut Rasch; Michael T Hirschmann Journal: Knee Surg Sports Traumatol Arthrosc Date: 2017-05-27 Impact factor: 4.342
Authors: U Heilmeier; K Mamoto; K Amano; B Eck; M Tanaka; J A Bullen; B J Schwaiger; J L Huebner; T V Stabler; V B Kraus; C B Ma; T M Link; X Li Journal: Osteoarthritis Cartilage Date: 2019-09-14 Impact factor: 6.576