TY - JOUR
T1 - Double inversion recovery MRI versus contrast-enhanced MRI for evaluation of knee synovitis in juvenile idiopathic arthritis
AU - Verkuil, Floris
AU - Hemke, Robert
AU - van Gulik, E. Charlotte
AU - Barendregt, Anouk M.
AU - Rashid, Amara Nassar-Sheikh
AU - Schonenberg-Meinema, Dieneke
AU - Dolman, Koert M.
AU - Deurloo, Eline E.
AU - van Dijke, Kees F.
AU - Harder, J. Michiel den
AU - Kuijpers, Taco W.
AU - van den Berg, J. Merlijn
AU - Maas, Mario
N1 - Funding Information: The authors are grateful for the research grant received from ReumaNederland (NR 13-1-402) and the support by MSK Synergy. ReumaNederland and MSK Synergy were not involved in designing or conducting this study, did not have access to the data, and were not involved in data analysis or preparation of this manuscript. Publisher Copyright: © 2022, The Author(s).
PY - 2022/12/1
Y1 - 2022/12/1
N2 - Background: Double inversion recovery (DIR) MRI has the potential to accentuate the synovium without using contrast agents, as it allows simultaneous signal suppression of fluid and fat. The purpose of this study was (1) to compare DIR MRI to conventional contrast-enhanced (CE) MRI for delineation of the synovium in the knee in children with juvenile idiopathic arthritis (JIA) and (2) to assess the agreement between DIR MRI and CE-MRI regarding maximal synovial thickness measurements. Results: In this prospective study, 26 children with JIA who consecutively underwent 3.0-T knee MRI between January 2018 and January 2021 were included (presence of knee arthritis: 13 [50%]; median age: 14 years [interquartile range [IQR]: 11–17]; 14 girls). Median confidence to depict the synovium (0–100 mm visual analogue scale; scored by 2 readers [consensus based]) was 88 (IQR: 79–97) for DIR MRI versus 100 (IQR: 100–100) for CE-MRI (p value = <.001). Maximal synovial thickness per child (millimeters; scored by 4 individual readers) on DIR MRI was greater (p value = <.001) in the children with knee arthritis (2.4 mm [IQR: 2.1–3.1]) than in those without knee arthritis (1.4 mm [IQR: 1.0–1.6]). Good inter-technique agreement for maximal synovial thickness per child was observed (rs = 0.93 [p value = <.001]; inter-reader reliability: ICC DIR MRI = 0.87 [p value = <.001], ICC CE-MRI = 0.90 [p value = <.001]). Conclusion: DIR MRI adequately delineated the synovium in the knee of children with JIA and enabled synovial thickness measurement similar to that of CE-MRI. Our results demonstrate that DIR MRI should be considered as a child-friendly alternative to CE-MRI for evaluation of synovitis in children with (suspected) JIA.
AB - Background: Double inversion recovery (DIR) MRI has the potential to accentuate the synovium without using contrast agents, as it allows simultaneous signal suppression of fluid and fat. The purpose of this study was (1) to compare DIR MRI to conventional contrast-enhanced (CE) MRI for delineation of the synovium in the knee in children with juvenile idiopathic arthritis (JIA) and (2) to assess the agreement between DIR MRI and CE-MRI regarding maximal synovial thickness measurements. Results: In this prospective study, 26 children with JIA who consecutively underwent 3.0-T knee MRI between January 2018 and January 2021 were included (presence of knee arthritis: 13 [50%]; median age: 14 years [interquartile range [IQR]: 11–17]; 14 girls). Median confidence to depict the synovium (0–100 mm visual analogue scale; scored by 2 readers [consensus based]) was 88 (IQR: 79–97) for DIR MRI versus 100 (IQR: 100–100) for CE-MRI (p value = <.001). Maximal synovial thickness per child (millimeters; scored by 4 individual readers) on DIR MRI was greater (p value = <.001) in the children with knee arthritis (2.4 mm [IQR: 2.1–3.1]) than in those without knee arthritis (1.4 mm [IQR: 1.0–1.6]). Good inter-technique agreement for maximal synovial thickness per child was observed (rs = 0.93 [p value = <.001]; inter-reader reliability: ICC DIR MRI = 0.87 [p value = <.001], ICC CE-MRI = 0.90 [p value = <.001]). Conclusion: DIR MRI adequately delineated the synovium in the knee of children with JIA and enabled synovial thickness measurement similar to that of CE-MRI. Our results demonstrate that DIR MRI should be considered as a child-friendly alternative to CE-MRI for evaluation of synovitis in children with (suspected) JIA.
KW - Double inversion recovery MRI
KW - Juvenile idiopathic arthritis
KW - Synovitis
UR - http://www.scopus.com/inward/record.url?scp=85140242841&partnerID=8YFLogxK
U2 - https://doi.org/10.1186/s13244-022-01299-0
DO - https://doi.org/10.1186/s13244-022-01299-0
M3 - Article
C2 - 36264355
SN - 1869-4101
VL - 13
JO - Insights into imaging
JF - Insights into imaging
IS - 1
M1 - 167
ER -