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Rheumatology International

, Volume 39, Issue 12, pp 2111–2118 | Cite as

Computed diffusion-weighted imaging for differentiating synovial proliferation from joint effusion in hand arthritis

  • Yuki Tanaka
  • Motoshi Fujimori
  • Koichi Murakami
  • Hiroyuki Sugimori
  • Nozomi Oki
  • Takatoshi Aoki
  • Tamotsu KamishimaEmail author
Imaging
  • 34 Downloads

Abstract

The objective of this study is to investigate computed DWI (cDWI) as an alternative method to contrast-enhanced MRI in comparison with directory measured DWI (mDWI) and apparent diffusion coefficient (ADC) for differentiating synovial proliferation from joint effusion. Nine patients suspected with RA (5 women) were included in this study. A radiologist identified region of interest (ROI) based on STIR, and evaluated using a 5-point grading scale of 0 (fluid) to 4 (synovial proliferation) according to the degree of contrast enhancement within the ROI. cDWI was synthesized for b values from 1000 to 2000 at 200 s/mm2 intervals using the combination of b values at mDWI. In addition to ADC values, contrast ratios were calculated using signal intensity for each ROI on the mDWI and cDWI. Visual assessment by a radiologist was conducted between pairs of STIR image and mDWI or cDWI. ROI grades were most significantly correlated with cDWI2000 based on b values of 400–1000 s/mm2 (rs = 0.405, p < 0.01). The area under the curve of cDWI2000 based on b values of 400–1000 s/mm2 (0.762) was larger than that of ADC values (0.570–0.608) when comparing low versus high contrast enhancement grades. Both cDWI1800 (200–1000) and cDWI2000 (400–1000) demonstrated high sensitivity and specificity in visual assessment (84.6% and 66.7%, respectively). The cDWI2000 based on b values of 400–1000 s/mm2 may be useful for noninvasive differentiation of synovial proliferation from joint effusion in hand arthritis.

Keywords

Arthritis Synovial proliferation MRI Computed diffusion-weighted imaging 

Notes

Author contributions

YT: substantial contributions to the analysis of the data for the work; and drafting the work or revising it critically for important intellectual content; and final approval of the version to be published; and agreement to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved. MF: substantial contributions to the design of the work, the acquisition, analysis, and interpretation of data for the work; and drafting the work or revising it critically for important intellectual content; and final approval of the version to be published; and agreement to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved. KM: substantial contributions to the conception and design of the work; and drafting the work or revising it critically for important intellectual content; and final approval of the version to be published; and agreement to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved. HS: substantial contributions to the conception and design of the work; and drafting the work or revising it critically for important intellectual content; and final approval of the version to be published; and agreement to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved. NO: substantial contributions to the conception and design of the work; and drafting the work or revising it critically for important intellectual content; and final approval of the version to be published; and agreement to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved. TA: substantial contributions to the conception and design of the work; and drafting the work or revising it critically for important intellectual content; and final approval of the version to be published; and agreement to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved. TK: substantial contributions to the conception and design of the work; and drafting the work or revising it critically for important intellectual content; and final approval of the version to be published; and agreement to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

Funding

This work has no funding support.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Informed consent

Informed consent was waivered because of the retrospective study design.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Graduate School of Health SciencesHokkaido UniversitySapporoJapan
  2. 2.AIC Yaesu ClinicTokyoJapan
  3. 3.Faculty of Health SciencesHokkaido UniversitySapporoJapan
  4. 4.Department of Radiological SciencesNagasaki University Graduate School of Biomedical SciencesNagasakiJapan
  5. 5.Department of Radiology, School of MedicineUniversity of Occupational and Environmental HealthKitakyushuJapan

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