title: Aiming for a shorter rheumatoid arthritis MRI protocol: can contrast-enhanced MRI replace T2 for the detection of bone marrow oedema?
abstract: OBJECTIVE
  To determine whether T1 post-gadolinium chelate images (T1Gd) can replace T2-weighted images (T2) for evaluating bone marrow oedema (BME), thereby allowing a shorter magnetic resonance imaging (MRI) protocol in rheumatoid arthritis (RA).
  
  
  METHODS
  In 179 early arthritis patients and 43 advanced RA patients, wrist and metacarpophalangeal joints were examined on a 1.5-T extremity MRI system with a standard protocol (coronal T1, T2 fat-saturated and coronal and axial T1 fat-saturated after Gd). BME was scored according to OMERACT RAMRIS by two observers with and without T2 images available. Agreement was assessed using intraclass correlation coefficients (ICCs) for semi-quantitative scores and test characteristics with T2 images as reference.
  
  
  RESULTS
  Agreement between scores based on T2 and T1Gd images was excellent ICC (0.80-0.99). At bone level, sensitivity and specificity of BME on T1Gd compared to T2 were high for both patient groups and both readers (all ≥80 %).
  
  
  CONCLUSIONS
  T1Gd and T2 images are equally suitable for evaluating BME. Because contrast is usually administered to assess (teno)synovitis, a short MRI protocol of T1 and T1Gd is sufficient in RA.
  
  
  CONCLUSIONS
  • Bone marrow oedema scores are equal on T2 and T1-Gd-chelate enhanced sequences. • Agreement between scores based on T2 and T1-Gd-chelate images was excellent. • Sensitivity and specificity for presence of bone marrow oedema were high. • A short protocol without T2 images suffices in rheumatoid arthritis patients.
authors: Department of Radiology, Leiden University Medical Center, P.O. Box 9600, 2300 RC, Leiden, The Netherlands, w.stomp@lumc.nl.
authors: Wouter
authors: W
authors: Stomp
authors: Annemarie
authors: A
authors: Krabben
authors: Désirée
authors: D
authors: van der Heijde
authors: Tom W J
authors: TW
authors: Huizinga
authors: Johan L
authors: JL
authors: Bloem
authors: Annette H M
authors: AH
authors: van der Helm-van Mil
authors: Monique
authors: M
authors: Reijnierse
mesh_terms: D000368:Aged; D001172:Arthritis, Rheumatoid / Q000150:complications / Q000175:diagnosis*; D001853:Bone Marrow / Q000473:pathology*; D003287:Contrast Media; D003937:Diagnosis, Differential; D004487:Edema / Q000175:diagnosis* / Q000209:etiology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008662:Metacarpophalangeal Joint / Q000473:pathology*; D008875:Middle Aged; D012372:ROC Curve; D015203:Reproducibility of Results
chemical_list: D003287:Contrast Media