title: Diagnostic performance of three-dimensional MR maximum intensity projection for the assessment of synovitis of the hand and wrist in rheumatoid arthritis: A pilot study.
abstract: OBJECTIVE
  To evaluate the diagnostic performance of three-dimensional (3D) MR maximum intensity projection (MIP) in the assessment of synovitis of the hand and wrist in rheumatoid arthritis (RA) compared to 3D contrast-enhanced magnetic resonance imaging (CE-MRI).
  
  
  METHODS
  Twenty-five patients with RA underwent MR examinations. 3D MR MIP images were derived from the enhanced images. MR images were reviewed by two radiologists for the presence and location of synovitis of the hand and wrist. The diagnostic sensitivity, specificity and accuracy of 3D MIP were, respectively, calculated with the reference standard 3D CE-MRI.
  
  
  RESULTS
  In all subjects, 3D MIP images yielded directly and clearly the presence and location of synovitis with just one image. Synovitis demonstrated high signal intensity on MIP images. The k-values for the detection of articular synovitis indicated excellent interobserver agreements using 3D MIP images (k=0.87) and CE-MR images (k=0.91), respectively. 3D MIP demonstrated a sensitivity, specificity and accuracy of 91.07%, 98.57% and 96.0%, respectively, for the detection of synonitis.
  
  
  CONCLUSIONS
  3D MIP can provide a whole overview of lesion locations and a reliable diagnostic performance in the assessment of articular synovitis of the hand and wrist in patients with RA, which has potential value of clinical practice.
authors.affiliation: Department of Radiology, Tianjin Medical University Cancer Institute and Hospital, National Clinical Reseaech Center for Cancer, Tianjin, Key Laboratory of Cancer Prevention and Therapy, Tianjin 300060, China. Electronic address: lixb@bjmu.edu.cn.
authors.forename: Xubin
authors.initials: X
authors.lastname: Li
authors.affiliation: Department of Radiology, Peking University People's Hospital, Beijing 100044, China.
authors.forename: Xia
authors.initials: X
authors.lastname: Liu
authors.affiliation: Department of Radiology, Peking University People's Hospital, Beijing 100044, China.
authors.forename: Xiangke
authors.initials: X
authors.lastname: Du
authors.affiliation: Department of Radiology, Tianjin Medical University Cancer Institute and Hospital, National Clinical Reseaech Center for Cancer, Tianjin, Key Laboratory of Cancer Prevention and Therapy, Tianjin 300060, China.
authors.forename: Zhaoxiang
authors.initials: Z
authors.lastname: Ye
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D003287:Contrast Media; D005260:Female; D006225:Hand / Q000473:pathology*; D006801:Humans; D007089:Image Enhancement / Q000379:methods*; D007090:Image Interpretation, Computer-Assisted / Q000379:methods*; D021621:Imaging, Three-Dimensional / Q000379:methods*; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D016037:Single-Blind Method; D013585:Synovitis / Q000473:pathology*; D014953:Wrist / Q000473:pathology*; D055815:Young Adult
chemical_list: D003287:Contrast Media
keywords: Magnetic resonance imaging; Maximum intensity projection; Rheumatoid arthritis