title: Dynamic contrast-enhanced magnetic resonance imaging of metacarpophalangeal joints reflects histological signs of synovitis in rheumatoid arthritis.
abstract: BACKGROUND
  Synovial inflammation and joint destruction in rheumatoid arthritis (RA) may progress despite clinical remission. Dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) is increasingly used to detect synovial inflammation in RA. Although small joints such as metacarpophalangeal (MCP) joints are mainly affected by RA, MRI findings have never been directly compared to histological synovitis in MCP synovial tissue. The objective of the current study was therefore to analyse if DCE-MRI relates to histological signs of synovitis small RA joints.
  
  
  METHODS
  In 9 RA patients, DCE-MRI (3 Tesla, dynamic 2D T1 weighted turbo-flash sequence) of the hand was performed prior to arthroscopically-guided synovial biopsies from the second MCP of the imaged hand. Maximum enhancement (ME), rate of early enhancement, and maximum rate of enhancement were assessed in the MCP. Synovial biopsies were stained for determination of sublining CD68 and the Synovitis Score. Correlations between MRI and histological data were calculated according to Spearman.
  
  
  RESULTS
  ME of the MCP significantly correlated to sublining CD68 staining (r = 0.750, P = 0.02), the Synovitis Score (r = 0.743, P = 0.02), and the subscores for lining layer hypertrophy (r = 0.789, P = 0.01) and cellular density (r = 0.842; P = 0.004).
  
  
  CONCLUSIONS
  Perfusion imaging of synovial tissue in RA finger joints employing DCE-MRI reflects histological synovial inflammation. According to our study, ME is the most closely associated parameter amongst the measures considered.
authors.forename: Stefan
authors.initials: S
authors.lastname: Vordenbäumen
authors.forename: Christoph
authors.initials: C
authors.lastname: Schleich
authors.forename: Tim
authors.initials: T
authors.lastname: Lögters
authors.forename: Philipp
authors.initials: P
authors.lastname: Sewerin
authors.forename: Ellen
authors.initials: E
authors.lastname: Bleck
authors.forename: Thomas
authors.initials: T
authors.lastname: Pauly
authors.forename: Anja
authors.initials: A
authors.lastname: Müller-Lutz
authors.forename: Gerald
authors.initials: G
authors.lastname: Antoch
authors.forename: Matthias
authors.initials: M
authors.lastname: Schneider
authors.forename: Falk
authors.initials: F
authors.lastname: Miese
authors.forename: Benedikt
authors.initials: B
authors.lastname: Ostendorf
mesh_terms: D000328:Adult; D000368:Aged; D018501:Antirheumatic Agents / Q000627:therapeutic use; D001172:Arthritis, Rheumatoid / Q000000981:diagnostic imaging* / Q000188:drug therapy / Q000473:pathology; D003287:Contrast Media; D005260:Female; D019786:Gadolinium DTPA; D006801:Humans; D007089:Image Enhancement / Q000379:methods; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008662:Metacarpophalangeal Joint / Q000000981:diagnostic imaging*; D008875:Middle Aged; D011859:Radiography; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D013585:Synovitis / Q000175:diagnosis / Q000000981:diagnostic imaging*
chemical_list: D018501:Antirheumatic Agents; D003287:Contrast Media; D019786:Gadolinium DTPA