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Synovitis maps for the assessment of inflammatory diseases of the hand

Karlo, Christoph ; Zanetti, Marco ; Stolzmann, Paul ; Steurer-Dober, Isabelle ; Brunner, Florian ; Hodler, Jürg ; Pfirrmann, Christian

In: European Radiology, 2011, vol. 21, no. 7, p. 1499-1508

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    Title
    • Synovitis maps for the assessment of inflammatory diseases of the hand
    Author
    • Karlo, Christoph. Department of Radiology, Kantonsspital Luzern, Luzern, Switzerland
    • Zanetti, Marco. Department of Radiology, University Hospital Balgrist, Zurich, Switzerland
    • Stolzmann, Paul. Department of Radiology, University Hospital Balgrist, Zurich, Switzerland
    • Steurer-Dober, Isabelle. Department of Radiology, University Hospital Balgrist, Zurich, Switzerland
    • Brunner, Florian. Department of Rheumatology, University Hospital Balgrist, Zurich, Switzerland
    • Hodler, Jürg. Department of Radiology, University Hospital Balgrist, Zurich, Switzerland
    • Pfirrmann, Christian. Department of Radiology, University Hospital Balgrist, Zurich, Switzerland
    Document Type
    • Postprint
    OAI-PMH Identifier
    • oai:doc.rero.ch:315467
    Summary
    Objectives: To compare accuracy and review times of FLASH-MRI-derived synovitis maps (SM) with conventional MR images (cMRI) in the assessment of articular synovitis and tenosynovitis of the hand. Methods: 80 hands in 40 patients (mean age, 48years; range, 15-72years) were assessed for synovitis on cMRI and SM by two readers independently. Reporting times and diagnostic confidence (scale: 1 = least, 5 = most confident) were measured. Results from an assessment of a panel of senior musculoskeletal radiologists served as the standard of reference. Results: Sensitivity and specificity for the detection of articular synovitis were 0.91/1.00 (R1) and 1.00/0.67 (R2) on cMRI and 0.87/0.75 (R1) and 0.91/0.45 (R2) on SM and for the detection of tenosynovitis 0.95/0.63 (R1) and 0.67/0.79 (R2) on cMRI and 0.67/0.89 (R1) and 0.38/1.00 (R2) on SM. Mean review times (cMRI/SM, sec) were 142/37 (R1) and 167/25 (R2). Mean diagnostic confidence (cMRI/SM) was 3.7/3.4 (R1) and 3.2/3.5 (R2) for articular synovitis and 4.0/4.0 (R1), 3.3/3.7 (R2) for tenosynovitis. Conclusion: Synovitis maps provide a comparable diagnostic accuracy to conventional MR images in the assessment of articular synovitis and tenosynovitis of the hand. Because of short review times, synovitis maps provide a fast overview of locations with synovial enhancement