title: Dynamic contrast-enhanced 3-T magnetic resonance imaging: a method for quantifying disease activity in early polyarthritis.
abstract: OBJECTIVE
  To determine whether measurement of synovial enhancement and thickness quantification parameters with 3.0-Tesla magnetic resonance imaging (3-T MRI) can reliably quantify disease activity in patients with early polyarthritis.
  
  
  METHODS
  Eighteen patients (16 women, 2 men; mean age 46 years) with early polyarthritis with less than 12 months of symptoms were included. MRI examination using 3-T device was performed by a new approach including both wrists and hands simultaneously in the examination field-of-view. MRI scoring of disease activity included quantification of synovial enhancement with simple measurements such as rate of early enhancement (REE; REE(57) = S(57)/S(200), where S(57) and S(200) are the signal intensities 57 s and 200 s after gadolinium injection) and rate of relative enhancement (RE; RE = S(200) - S(0)). Both wrists and hands were scored according to the Rheumatoid Arthritis MRI Scoring System (RAMRIS) for synovitis. Disease activity was clinically assessed by the 28-joint Disease Activity Score (DAS28).
  
  
  RESULTS
  DAS28 score was strongly correlated with RE (r = 0.8331, p < 0.0001), REE (r = 0.8112, p < 0.0001), and RAMRIS score for synovitis (r = 0.7659, p < 0.0002). An REE score above 0.778 accurately identified patients with clinically active disease (sensitivity 92%; specificity 67%; p < 0.05). A statistically significant difference was observed in the RE, REE, and RAMRIS scores for synovitis between patients with active and inactive disease (p < 0.05).
  
  
  CONCLUSIONS
  Our findings support the use of 3-T dynamic contrast-enhanced MRI for precise quantification of disease activity and for discriminating active disease from inactive disease in early polyarthritis.
authors.affiliation: Rheumatology Research Unit, Instituto de Medicina Molecular, Faculdade de Medicina da Universidade de Lisboa, Lisbon, Portugal. marcio.navalho@gmail.com
authors.forename: Márcio
authors.initials: M
authors.lastname: Navalho
authors.forename: Catarina
authors.initials: C
authors.lastname: Resende
authors.forename: Ana Maria
authors.initials: AM
authors.lastname: Rodrigues
authors.forename: Augusto
authors.initials: A
authors.lastname: Gaspar
authors.forename: João Eurico
authors.initials: JE
authors.lastname: Fonseca
authors.forename: Helena
authors.initials: H
authors.lastname: Canhão
authors.forename: Jorge
authors.initials: J
authors.lastname: Campos
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001168:Arthritis / Q000473:pathology*; D003287:Contrast Media; D042241:Early Diagnosis; D005260:Female; D019786:Gadolinium DTPA; D006801:Humans; D007089:Image Enhancement / Q000379:methods; D007090:Image Interpretation, Computer-Assisted / Q000379:methods*; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D055815:Young Adult
chemical_list: D003287:Contrast Media; D019786:Gadolinium DTPA