title: Magnetic resonance and ultrasonography real-time fusion imaging of the hand and wrist in osteoarthritis and rheumatoid arthritis.
abstract: OBJECTIVE
  To investigate the role of a new hybrid imaging modality, integrated in the US equipment and derived by a real-time MRI and US fusion process, in the hand and wrist joints of a small group of rheumatic patients.
  
  
  METHODS
  Consecutive patients with OA and RA with hand and wrist involvement were studied. Clinical assessment, physical examination, hand and wrist radiography and laboratory tests were carried out. After performing 0.2T MRI (T₁, T₂ and short time inversion recovery sequences) of the dominant hand and wrist, images were recorded in a US machine equipped with a virtual navigator system. Ultrasonography was performed in the same joints using an 18 MHz linear probe. Image MRI/US superposition was carried out, with real-time contemporary visualization of the US and related MRI images. Randomly selected stored images of different joints were subsequently re-analysed by a different operator. Concordance between the static and dynamic evaluations was assessed.
  
  
  RESULTS
  Nine patients (six with OA and three with RA) were studied. The real-time MRI/US overlap provided fusion images of both tools. A striking concordance in the visualization of the bony profile was found with evidence of pronounced osteophytes in OA and bone erosions in RA. The analysis of stored selected images demonstrated a high concordance between real-time and static assessment.
  
  
  CONCLUSIONS
  MRI/US fusion imaging gives a composite set of information with accurate anatomical correlations.
authors.affiliation: Dipartimento di Medicina Interna e Specialità Mediche, UOC Reumatologia, Sapienza Università di Roma, Viale del Policlinico 155, 00161 Rome, Italy. annamaria.iagnocco@uniroma1.it
authors.forename: Annamaria
authors.initials: A
authors.lastname: Iagnocco
authors.forename: Chiara
authors.initials: C
authors.lastname: Perella
authors.forename: Maria Antonietta
authors.initials: MA
authors.lastname: D'Agostino
authors.forename: Emanuela
authors.initials: E
authors.lastname: Sabatini
authors.forename: Guido
authors.initials: G
authors.lastname: Valesini
authors.forename: Philip G
authors.initials: PG
authors.lastname: Conaghan
mesh_terms: D000368:Aged; D001172:Arthritis, Rheumatoid / Q000175:diagnosis*; D001175:Arthrography; D003952:Diagnostic Imaging / Q000379:methods*; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted / Q000379:methods*; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D010003:Osteoarthritis / Q000175:diagnosis*; D014463:Ultrasonography; D014955:Wrist Joint / Q000000981:diagnostic imaging / Q000473:pathology*