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Diagnostic performance of double inversion recovery MRI sequence for synovitis of the wrist joints in rheumatoid arthritis

  • Magnetic Resonance Imaging
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Abstract

Purpose

To assess the diagnostic accuracy of double inversion recovery (DIR) magnetic resonance imaging (MRI) sequences for synovitis of the wrist joints in patients with rheumatoid arthritis (RA).

Material and methods

Participants with newly diagnosed RA were enrolled between November 2019 and November 2020. MRI examinations of the wrist joints were performed using a contrast-enhanced T1-weighted imaging sequence (CE-T1WI) and DIR sequence. We measured synovitis score, number of synovial areas, synovial volume, mean synovium-to-bone signal ratio (SBR), and synovial contrast-to-noise ratio (SNR). The inter-reviewer agreement rated on a four-point scale was evaluated by calculating the weighted k statistics. Two MRI sequences were assessed using Bland–Altman analyses, and the diagnostic performance of DIR images was calculated using the chi-square test.

Results

A total of 47 participants were evaluated, and 282 joint regions in 5076 images were reviewed by two readers. There was no significant difference in synovitis scores (P = 0.67), number of synovial areas (P = 0.89), and synovial volume (P = 0.086) between the two MRI sequences. DIR images showed better SBR and SNR (all P < 0.01). There was good agreement between the two reviewers in terms of synovitis distribution (κ = 0.79). The synovitis was well agreed upon by the two readers according to Bland–Altman analyses. Using CE-T1WI as the reference standard, DIR imaging demonstrated a sensitivity of 94.1% and a specificity of 84.6% at the patient level.

Conclusion

The non-contrast DIR sequence showed good consistency with CE-T1WI and potential for evaluating synovitis in patients with RA.

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Acknowledgements

We thank all patients and all of the medical staff involved in the collection of the samples for this study.

Funding

No funding was received for conducting this study.

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Authors and Affiliations

  1. Department of Radiology, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200001, China

    Weiwei Ma, Wei Zhang, Shiteng Suo, Jinyan Zu, Qiuying Yao & Jiaxu Wei

  2. Department of Radiology, Xinhua Hospital Chongming Branch, Shanghai Jiao Tong University School of Medicine, Shanghai, 202150, China

    Jianguo Cai

  3. Department of Radiology, Shanghai East Hospital Affiliated to Tongji University, 150 Jimo Road, Shanghai, 200120, China

    Qing Lu

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Contributions

All authors contributed to material preparation, data collection and analysis. The study conception and design were performed by WM and QL. The first draft of the manuscript was written by QL and WM. All authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

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Correspondence to Qing Lu.

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The authors have no relevant financial or non-financial interests to disclose.

Ethics approval

This retrospective study was performed in line with the principles of the Declaration of Helsinki. Approval was granted by the Ethics Committee of Renji Hospital, Shanghai Jiao Tong University School of Medicine. We would like to thank Dr. Jia Li for taking care of the patients in this study.

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Informed consent was obtained from all participants.

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The authors affirm that human research participants provided informed consent for publication of the images in Figs. 1, 2 and 4.

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Ma, W., Cai, J., Zhang, W. et al. Diagnostic performance of double inversion recovery MRI sequence for synovitis of the wrist joints in rheumatoid arthritis. Radiol med 128, 978–988 (2023). https://doi.org/10.1007/s11547-023-01669-8

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