title: Synovitis maps for the assessment of inflammatory diseases of the hand.
abstract: OBJECTIVE
  To compare accuracy and review times of FLASH-MRI-derived synovitis maps (SM) with conventional MR images (cMRI) in the assessment of articular synovitis and tenosynovitis of the hand.
  
  
  METHODS
  80 hands in 40 patients (mean age, 48 years; range, 15-72 years) were assessed for synovitis on cMRI and SM by two readers independently. Reporting times and diagnostic confidence (scale: 1 = least, 5 = most confident) were measured. Results from an assessment of a panel of senior musculoskeletal radiologists served as the standard of reference.
  
  
  RESULTS
  Sensitivity and specificity for the detection of articular synovitis were 0.91/1.00 (R1) and 1.00/0.67 (R2) on cMRI and 0.87/0.75 (R1) and 0.91/0.45 (R2) on SM and for the detection of tenosynovitis 0.95/0.63 (R1) and 0.67/0.79 (R2) on cMRI and 0.67/0.89 (R1) and 0.38/1.00 (R2) on SM. Mean review times (cMRI/SM, sec) were 142/37 (R1) and 167/25 (R2). Mean diagnostic confidence (cMRI/SM) was 3.7/3.4 (R1) and 3.2/3.5 (R2) for articular synovitis and 4.0/4.0 (R1), 3.3/3.7 (R2) for tenosynovitis.
  
  
  CONCLUSIONS
  Synovitis maps provide a comparable diagnostic accuracy to conventional MR images in the assessment of articular synovitis and tenosynovitis of the hand. Because of short review times, synovitis maps provide a fast overview of locations with synovial enhancement.
authors.affiliation: Department of Radiology, University Hospital Zurich, Rämistrasse 100, 8091 Zurich, Switzerland. christoph.karlo@usz.ch
authors.forename: Christoph
authors.initials: C
authors.lastname: Karlo
authors.forename: Marco
authors.initials: M
authors.lastname: Zanetti
authors.forename: Paul
authors.initials: P
authors.lastname: Stolzmann
authors.forename: Isabelle
authors.initials: I
authors.lastname: Steurer-Dober
authors.forename: Florian
authors.initials: F
authors.lastname: Brunner
authors.forename: Jürg
authors.initials: J
authors.lastname: Hodler
authors.forename: Christian W A
authors.initials: CW
authors.lastname: Pfirrmann
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D016009:Chi-Square Distribution; D003287:Contrast Media; D005260:Female; D006225:Hand; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009942:Organometallic Compounds; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D018709:Statistics, Nonparametric; D013585:Synovitis / Q000175:diagnosis*; D013717:Tenosynovitis / Q000175:diagnosis*
chemical_list: D003287:Contrast Media; D009942:Organometallic Compounds; C090600:gadobutrol