Background/Purpose: The study was performed to quantify dynamic contrast enhanced (DCE) and diffusion tensor imaging (DTI) metrics in synovium of patients with tubercular synovitis (TS) and chronic inflammatory synovitis (CIS) with an aim to discriminate between TS and CIS.

Methods:

Seventy-three patients with knee synovitis (18-75 years, 51 Male) underwent conventional, DTI and DCE-MRI.­ DTI and DCE data were quantified from the segmented contrast enhanced synovium. Descriptive statistics, Box-plot with Tukey’s hinges were produced for all DTI (fractional anisotropy, FA and mean diffusivity, MD) and perfusion metrics (blood volume, BV; blood flow, BF and volume transfer constant, k^trans). The mean difference between the two groups was compared using Student’s t-test for independent samples. To classify subjects into TS and CIS, two-group discriminant function analysis with stepwise inclusion of variables was performed.

Results: Out of 73 patients, 15 were detected to have TS, while rests were found to have CIS. DCE (BV, BF) and DTI metrics (FA, MD) were significantly (p<0.001) different between the two groups (TS:BV=14.35±4.21 ml/100gm, CIS_BV=4.57±2.77 ml/100gm,  TS BF=155.7±29.5 ml/100gm/min, CIS BF=94.9±34.5 ml/100gm/min, TS FA=0.26±0.02, MD=1.23±0.39×10^-3 mm²sec^-1; CIS FA=0.20±0.02, MD=1.7±0.5×10^-3 mm²sec^-1). Discriminant analysis revealed BV and FA as discriminators of TS and CIS. It classified 93.3% of TS and 100% of CIS correctly. The overall model classified 98.6% cases correctly.

Conclusion:

DTI and DCE-MRI metrics are able to discriminate TS from CIS. FA and BV may be used as non-invasive image biomarkers for its differentiation.

---

« Back to 2012 ACR/ARHP Annual Meeting

ACR Meeting Abstracts - https://acrabstracts.org/abstract/diffusion-tensor-and-dynamic-contrast-enhanced-perfusion-imaging-metrics-discriminate-chronic-tubercular-synovitis-from-chronic-inflammatory-synovitis-of-the-knee/