title: Dynamic contrast-enhanced magnetic resonance imaging can play a role in predicting flare in juvenile idiopathic arthritis.
abstract: OBJECTIVE
  The study was performed to determine whether conventional and dynamic contrast-enhanced (DCE) magnetic resonance imaging (MRI) parameters of a previously affected target joint in patients with clinically inactive juvenile idiopathic arthritis (JIA) have prognostic meaning for a flare of joint inflammation during follow-up.
  
  
  METHODS
  Thirty-two JIA patients with clinically inactive disease at the time of MRI of the knee were prospectively included. DCE-MRI provided both descriptive measures and time-intensity-curve shapes, representing functional properties of the synovium. Conventional MRI outcome measures included validated scores for synovial hypertrophy, bone marrow edema, cartilage lesions and bone erosions. During a 2-year period the patients were monitored by their pediatric rheumatologist and clinical flares were registered.
  
  
  RESULTS
  MRI analysis revealed synovial hypertrophy in 13 (39.4%) of the clinically inactive patients. Twelve patients (37.5%) had at least one flare during 2-year clinical follow-up. Persistently inactive and flaring patients differed significantly in the maximum enhancement of the synovium on the DCE-MRI (p<0.05), whereas no difference was found between these two groups in any of the baseline scores of conventional MRI.
  
  
  CONCLUSIONS
  Our prospective clinical follow-up study indicates that the assessment of 'maximum enhancement' upon DCE-MRI may be able to predict a clinical flare within 2 years in inactive JIA patients.
authors.affiliation: Department of Radiology, Academic Medical Center Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands; Department of Pediatric Hematology, Immunology, Rheumatology and Infectious Diseases, Emma Children's Hospital, Academic Medical Center Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands. Electronic address: c.m.nusman@amc.uva.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: Robert
authors.initials: R
authors.lastname: Hemke
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 Pediatric Hematology, Immunology, Rheumatology and Infectious Diseases, Emma Children's Hospital, Academic Medical Center Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands.
authors.forename: Dieneke
authors.initials: D
authors.lastname: Schonenberg-Meinema
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, Emma Children's Hospital, Academic Medical Center Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands.
authors.forename: Marion A J
authors.initials: MA
authors.lastname: van Rossum
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, Sint Lucas Andreas Hospital, Jan Tooropstraat 164, 1061 AE, Amsterdam, The Netherlands.
authors.forename: Koert M
authors.initials: KM
authors.lastname: Dolman
authors.affiliation: Department of Pediatric Hematology, Immunology, Rheumatology and Infectious Diseases, Emma Children's Hospital, Academic Medical Center Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands.
authors.forename: J Merlijn
authors.initials: JM
authors.lastname: van den Berg
authors.affiliation: Department of Radiology, Academic Medical Center Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands.
authors.forename: Mario
authors.initials: M
authors.lastname: Maas
authors.affiliation: Department of Pediatric Hematology, Immunology, Rheumatology and Infectious Diseases, Emma Children's Hospital, Academic Medical Center Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands.
authors.forename: Taco W
authors.initials: TW
authors.lastname: Kuijpers
mesh_terms: D000293:Adolescent; D001171:Arthritis, Juvenile / Q000000981:diagnostic imaging* / Q000473:pathology; D003287:Contrast Media; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007089:Image Enhancement / Q000379:methods*; D007719:Knee Joint / Q000000981:diagnostic imaging* / Q000473:pathology; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D011237:Predictive Value of Tests; D011446:Prospective Studies
chemical_list: D003287:Contrast Media
keywords: Flare; Juvenile idiopathic arthritis; Knee; Magnetic resonance imaging