The Value of Dynamic Contrast-Enhanced MRI and Delayed Gadolinium Enhanced MRI of the Cartilage in Patients with Early Rheumatoid Arthritis: Leads Local Hyperperfusion to Cartilage Loss?

Philipp Sewerin¹, Anja Mueller-Lutz², Christoph Schleich³, Florian Fichter⁴, Markus Eichner⁵, Ruben Sengewein⁶, Lien Le⁷, Hans-Jörg Wittsack⁸, Matthias Schneider⁹ and Benedikt Ostendorf^1,10, ¹Department and Hiller-Research-Unit for Rheumatology, Heinrich-Heine University, Düsseldorf, Germany, ²Dep. for diagnostic and interventional Radiology, Heinrich-Heine-University, Düsseldorf, Germany, ³Dep. for diagnostic and interventional Radiology, Heinrich-Heine University, Duesseldorf, Germany, ⁴Dep. for inverventional and diagnostic radiology, Heinrich-Heine University, Düsseldorf, Germany, ⁵Dep. for interventional and diagnositc radiology, Heinich-Heine University, Düsseldorf, Germany, ⁶Department and Hiller Research Unit for Rheumatology, Heinrich-Heine University, Düsseldorf, Germany, ⁷Ludwig-Maximilian University, Munich, Germany, ⁸Dep. for diagnostic and interventional radiology, Heinrich-Heine University, Düsseldorf, Germany, ⁹Policlinic for Rheumatology & Hiller Research Centre for Rheumatology, Heinrich-Heine-University Duesseldorf, Duesseldorf, Germany, ¹⁰Department of Rheumatology, Univ. Duesseldorf, Düsseldorf, Germany

Meeting: 2017 ACR/ARHP Annual Meeting

Date of first publication: September 18, 2017

Keywords: MRI and rheumatoid arthritis (RA)

Session Information

Date: Tuesday, November 7, 2017

Title: Imaging of Rheumatic Diseases Poster II

Session Type: ACR Poster Session C

Session Time: 9:00AM-11:00AM

Background/Purpose: To investigate the local inflammatory activity by using dynamic magnetic resonance imaging (MRI) and cartilage biochemical composition of the metacarpophalangeal joints (MCP) digits 2 and 3 by using Delayed Gadolinium-Enhanced MRI (dGEMRIC) in patients with early rheumatoid arthritis (eRA) treated with Methotrexat (MTX).

Methods: MCP joints of the index and middle finger of 28 patients with eRA from the AthroMark cohort were examined prior to MTX-therapy (baseline) as well as 3 and 6 months after initiation of MTX-therapy (follow up). Perfusion parameters and dGEMRIC index were calculated. OMERACT RA MRI score, including synovitis, edema and erosion subscores, and clinical parameters (CRP and DAS28) were registered at all time points.

Results: In follow-up measurements, the local perfusion in dynamic MRI decreased significantly between months 0 and 3 and between months 0 and 6. Decreasing of local perfusion correlates significantly with the DAS28 improvement at 3 months (p < 0.05). The extent of local inflammation (MCP II or MCP III) was significantly correlated with dGEMRIC values at all time points (p < 0.05). Furthermore, local inflammation and cartilage composite measurements showed significant correlation with edema subscore in follow up after 3 months and with RAMRIS and erosion subscore in follow up after 6 months (p < 0.05).

Conclusion: In patients with eRA synovial local hyperperfusion measured by dynamic MRI correlated significantly with the local cartilage composite and decreased significantly after 3 and 6 months after initiating MTX-therapy. Dynamic MRI seems to be a useful parameter of therapy success, since DAS28, RAMRIS and edema/erosion

Disclosure: P. Sewerin, None; A. Mueller-Lutz, None; C. Schleich, None; F. Fichter, None; M. Eichner, None; R. Sengewein, None; L. Le, None; H. J. Wittsack, None; M. Schneider, None; B. Ostendorf, None.

To cite this abstract in AMA style:

Sewerin P, Mueller-Lutz A, Schleich C, Fichter F, Eichner M, Sengewein R, Le L, Wittsack HJ, Schneider M, Ostendorf B. The Value of Dynamic Contrast-Enhanced MRI and Delayed Gadolinium Enhanced MRI of the Cartilage in Patients with Early Rheumatoid Arthritis: Leads Local Hyperperfusion to Cartilage Loss? [abstract]. Arthritis Rheumatol. 2017; 69 (suppl 10). https://acrabstracts.org/abstract/the-value-of-dynamic-contrast-enhanced-mri-and-delayed-gadolinium-enhanced-mri-of-the-cartilage-in-patients-with-early-rheumatoid-arthritis-leads-local-hyperperfusion-to-cartilage-loss/. Accessed .

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