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Joint Bone Spine
Volume 73, Issue 5, October 2006, Pages 518-522
 
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doi:10.1016/j.jbspin.2006.01.010    
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Copyright © 2006 Elsevier SAS All rights reserved.

Original article

Three-dimensional Doppler sonographic vascular imaging in regions with increased MR enhancement in inflamed wrists of patients with rheumatoid arthritis

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Johannes Strunka, Corresponding Author Contact Information, E-mail The Corresponding Author, Pascal Klingenbergera, Katinka Strubea, Georg Bachmannb, Ulf Müller-Ladnera and Alexander Klugeb

aDepartment of Rheumatology and Clinical Immunology, Kerckhoff-Clinic, University of Giessen, Benekestrasse 2-8, 61231 Bad Nauheim, Germany

bDepartment of Radiology, Kerckhoff-Clinic, 61231 Bad Nauheim, Germany


Received 29 August 2005; 
accepted 18 January 2006. 
Available online 29 March 2006.

Abstract

Objective

To compare three-dimensional (3D) power Doppler ultrasonography (PDUS) with contrast enhanced magnetic resonance imaging (MRI) in their capability to visualize synovial vascularity in inflamed wrists of patients with rheumatoid arthritis (RA).

Methods

Nine patients with RA showing clinically active arthritis of the wrist as determined by tenderness and swelling were examined by contrast enhanced MRI and 3D PDUS. Vascularity close to and inside the joint capsule was visualized by conventional power Doppler mode. In a region with high Doppler signal intensity (= region of interest/ROI) a 3D blood vessel tree was obtained by a free-hand sweep. 3D images were evaluated with regard to the number of blood vessels in the intra- and peri-articular region. MRI examinations were performed using a 1.5 T Scanner. In MRI, time resolved coronal contrast enhanced T1-weighted sequences with fat suppression were acquired during an 8 min period to assess tissue enhancement. Relative enhancement was calculated and compared to 3D PDUS findings.

Results

A 3D vascular tree consisting of peri- and intra-articular blood vessels could be demonstrated in the same anatomical ROI in which an increased gadolinium enhancement was measured by MRI in all examined RA patients. The number of penetrating vessels into the joint capsule, the number of intra-articular vessels and a semiquantitative estimation of the strength of blood flow were used to generate a 3D score for the intensity of synovial vascularity.

Conclusion

When compared with clinical symptoms and the gold standard dynamic MRI, 3D PDUS is a reliable imaging technique for assessing synovial vascularity in inflamed wrists of RA patients.

Keywords: Power Doppler ultrasonography; Three-dimensional ultrasound; Rheumatoid arthritis; Contrast enhanced magnetic resonance imaging

Article Outline

1. Introduction
2. Methods
3. Results
4. Discussion
References



Corresponding Author Contact InformationCorresponding author. Tel.: +49 6032 996 2109; fax: +49 6032 996 2184.

Joint Bone Spine
Volume 73, Issue 5, October 2006, Pages 518-522
 
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