title: Dynamic contrast-enhanced magnetic resonance imaging of the wrist in children with juvenile idiopathic arthritis.
abstract: BACKGROUND
  Dynamic contrast-enhanced MRI provides information on the heterogeneity of the synovium, the primary target of disease in children with juvenile idiopathic arthritis (JIA).
  
  
  OBJECTIVE
  To evaluate the feasibility of dynamic contrast-enhanced MRI in the wrist of children with JIA using conventional descriptive measures and time-intensity-curve shape analysis. To explore the association between enhancement characteristics and clinical disease status.
  
  
  METHODS
  Thirty-two children with JIA and wrist involvement underwent dynamic contrast-enhanced MRI with movement-registration and were classified using validated criteria as clinically active (n = 27) or inactive (n = 5). Outcome measures included descriptive parameters and the classification into time-intensity-curve shapes, which represent the patterns of signal intensity change over time. Differences in dynamic contrast-enhanced MRI outcome measures between clinically active and clinically inactive disease were analyzed and correlation with the Juvenile Arthritis Disease Activity Score was determined.
  
  
  RESULTS
  Comprehensive evaluation of disease status was technically feasible and the quality of the dynamic dataset was improved by movement registration. The conventional descriptive measure maximum enhancement differed significantly between clinically active and inactive disease (P = 0.019), whereas time-intensity-curve shape analysis showed no differences. Juvenile Arthritis Disease Activity Score correlated moderately with enhancing volume (P = 0.484).
  
  
  CONCLUSIONS
  Dynamic contrast-enhanced MRI is a promising biomarker for evaluating disease status in children with JIA and wrist involvement. Conventional descriptive dynamic contrast-enhanced MRI measures are better associated with clinically active disease than time-intensity-curve shape analysis.
authors.affiliation: Department of Pediatric Hematology, Immunology, Rheumatology and Infectious Disease, Academic Medical Center, Emma Children's Hospital, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands. c.m.nusman@amc.nl.|Department of Radiology, Academic Medical Center, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands. c.m.nusman@amc.nl.
authors.forename: Charlotte M
authors.initials: CM
authors.lastname: Nusman
authors.affiliation: Department of Radiology, Academic Medical Center, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands.
authors.forename: Cristina
authors.initials: C
authors.lastname: Lavini
authors.affiliation: Department of Radiology, Academic Medical Center, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands.
authors.forename: Robert
authors.initials: R
authors.lastname: Hemke
authors.affiliation: Department of Radiology, Academic Medical Center, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands.
authors.forename: Matthan W A
authors.initials: MW
authors.lastname: Caan
authors.affiliation: Department of Pediatric Hematology, Immunology, Rheumatology and Infectious Disease, Academic Medical Center, Emma Children's Hospital, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands.
authors.forename: Dieneke
authors.initials: D
authors.lastname: Schonenberg-Meinema
authors.affiliation: Department of Pediatrics, Sint Lucas Andreas Hospital, Jan Tooropstraat 164, 1061 AE, Amsterdam, The Netherlands.|Department of Pediatric Rheumatology, Reade Institute location Jan van Breemen, Doctor Jan van Breemenstraat 2, 1056 AB, Amsterdam, The Netherlands.
authors.forename: Koert M
authors.initials: KM
authors.lastname: Dolman
authors.affiliation: Department of Pediatric Rheumatology, Reade Institute location Jan van Breemen, Doctor Jan van Breemenstraat 2, 1056 AB, Amsterdam, The Netherlands.|Department of Pediatrics, Academic Medical Center, Emma Children's Hospital, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands.
authors.forename: Marion A J
authors.initials: MA
authors.lastname: van Rossum
authors.affiliation: Department of Pediatric Hematology, Immunology, Rheumatology and Infectious Disease, Academic Medical Center, Emma Children's Hospital, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands.
authors.forename: J Merlijn
authors.initials: JM
authors.lastname: van den Berg
authors.affiliation: Department of Pediatric Hematology, Immunology, Rheumatology and Infectious Disease, Academic Medical Center, Emma Children's Hospital, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands.
authors.forename: Taco W
authors.initials: TW
authors.lastname: Kuijpers
authors.affiliation: Department of Radiology, Academic Medical Center, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands.
authors.forename: Mario
authors.initials: M
authors.lastname: Maas
mesh_terms: D000293:Adolescent; D001171:Arthritis, Juvenile / Q000000981:diagnostic imaging*; D002648:Child; D003287:Contrast Media; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D007090:Image Interpretation, Computer-Assisted; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D014955:Wrist Joint / Q000000981:diagnostic imaging*
chemical_list: D003287:Contrast Media
keywords: Children; Dynamic contrast-enhanced magnetic resonance imaging; Juvenile idiopathic arthritis; Magnetic resonance imaging; Synovium; Wrist