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A simple, clinically usable whole-body MRI system of joint assessment in adolescents and young people with juvenile idiopathic arthritis.
Choida, Varvara; Bray, Timothy J P; van Vucht, Niels; Abbasi, Maaz Ali; Bainbridge, Alan P; Parry, Thomas; Mallett, Sue; Ciurtin, Coziana; Hall-Craggs, Margaret A.
Afiliación
  • Choida V; Centre for Medical Imaging, University College London, London, UK.
  • Bray TJP; Division of Medicine, Centre for Adolescent Rheumatology, University College London, UK.
  • van Vucht N; Department of Rheumatology, University College London Hospitals NHS Foundation Trust, London, UK.
  • Abbasi MA; Centre for Medical Imaging, University College London, London, UK.
  • Bainbridge AP; Department of Imaging, University College London Hospitals NHS Foundation Trust, London, UK.
  • Parry T; Department of Imaging, University College London Hospitals NHS Foundation Trust, London, UK.
  • Mallett S; Department of Imaging, University College London Hospitals NHS Foundation Trust, London, UK.
  • Ciurtin C; Centre for Medical Imaging, University College London, London, UK.
  • Hall-Craggs MA; Department of Medical Physics, University College Hospitals Trust, London, UK.
Rheumatology (Oxford) ; 63(SI2): SI219-SI227, 2024 Sep 01.
Article en En | MEDLINE | ID: mdl-38426363
ABSTRACT

OBJECTIVES:

To introduce and evaluate a simple method for assessing joint inflammation and structural damage on whole-body MRI (WBMRI) in juvenile idiopathic arthritis (JIA), which is usable in clinical practice.

METHODS:

The proposed system utilizes post-contrast Dixon WBMRI scans. Joints are assessed for synovitis (grade 0-2) and structural damage (present/absent) at 81 sites. The synovitis grading is based on features including above-normal intensity synovial enhancement, synovial hypertrophy, joint effusion, subarticular bone marrow oedema and peri-articular soft tissue oedema.This system was evaluated in a prospective study of 60 young people (47 patients with JIA and 13 controls with non-inflammatory musculoskeletal pain) who underwent a WBMRI. Three readers (blinded to diagnosis) independently reviewed all images and re-reviewed 20 individual scans. The intra- and inter-reader overall agreement (OA) and the intra- and inter-reader Gwet's agreement coefficients 2 (GAC2) were measured for the detection of a) participants with ≥1 joint with inflammation or structural damage and b) joint inflammation or structural damage for each joint.

RESULTS:

The inter-reader OA for detecting patients with ≥1 joint with inflammation, defined as grade 2 synovitis (G2), and ≥1 joint with structural damage were 80% and 73%, respectively. The intra-reader OA for readers 1-3 was 80-90% and 75-90%, respectively. The inter-reader OA and GAC2 for joint inflammation (G2) at each joint were both ≥85% for all joints but were lower if grade 1 synovitis was included as positive.

CONCLUSION:

The intra- and inter-reader agreements of this WBMRI assessment system are adequate for assessing objective joint inflammation and damage in JIA.
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Texto completo: 1 Bases de datos: MEDLINE Asunto principal: Artritis Juvenil / Sinovitis / Imagen por Resonancia Magnética / Imagen de Cuerpo Entero Límite: Adolescent / Adult / Child / Female / Humans / Male Idioma: En Revista: Rheumatology (Oxford) Asunto de la revista: REUMATOLOGIA Año: 2024 Tipo del documento: Article

Texto completo: 1 Bases de datos: MEDLINE Asunto principal: Artritis Juvenil / Sinovitis / Imagen por Resonancia Magnética / Imagen de Cuerpo Entero Límite: Adolescent / Adult / Child / Female / Humans / Male Idioma: En Revista: Rheumatology (Oxford) Asunto de la revista: REUMATOLOGIA Año: 2024 Tipo del documento: Article