Optimization of Quantitative Dynamic Postgadolinium MRI Technique Using Normalized Ratios for the Evaluation of Temporomandibular Joint Synovitis in Patients with Juvenile Idiopathic Arthritis

MR imaging has been shown to be useful in the diagnosis of juvenile idiopathic arthritis of the temporomandibular joint. Prior MR imaging approaches have relied mainly on the subjective interpretation of synovial enhancement as a marker for synovial inflammation. Although, more recently, several att...

Full description

Saved in:
Bibliographic Details
Published in:American journal of neuroradiology : AJNR 2017-12, Vol.38 (12), p.2344-2350
Main Authors: Caruso, P, Buch, K, Rincon, S, Hakimelahi, R, Peacock, Z S, Resnick, C M, Foster, C, Guidoboni, L, Donahue, T, Macdonald, R, Rothermel, H, Curtin, H D, Kaban, L B
Format: Article
Language:English
Subjects:
Adolescent
Adult
Arthritis
Arthritis, Juvenile - complications
Arthritis, Juvenile - diagnostic imaging
Child
Contrast Media
Evaluation
Feasibility studies
Female
Gadolinium
Head & Neck
Humans
Joint diseases
Magnetic resonance imaging
Magnetic Resonance Imaging - methods
Male
Mathematical models
Optimization
Patients
Retrospective Studies
Sampling
Sampling error
Synovitis
Synovitis - diagnostic imaging
Synovitis - etiology
Synovium
Temporomandibular joint
Temporomandibular Joint Disorders - diagnostic imaging
Temporomandibular Joint Disorders - etiology
Young Adult
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:MR imaging has been shown to be useful in the diagnosis of juvenile idiopathic arthritis of the temporomandibular joint. Prior MR imaging approaches have relied mainly on the subjective interpretation of synovial enhancement as a marker for synovial inflammation. Although, more recently, several attempts have been made to quantify synovial enhancement, these methods have not taken into account the dynamic enhancement characteristics of the temporomandibular joint and the effect of sampling time. Our aim was to develop a clinically feasible, reproducible, dynamic, contrast-enhanced MR imaging technique for the quantitative assessment of temporomandibular joint synovitis in patients with juvenile idiopathic arthritis and to study the effect of sampling time on the evaluation of synovitis. This was a retrospective study of all patients who had dynamic, contrast-enhanced coronal T1 3T MR imaging through the temporomandibular joint at our institution between January 1, 2015, and July 8, 2016. Patients in this cohort included those with a history of juvenile idiopathic arthritis and control patients who underwent MR imaging for other routine, clinical purposes. Synovial enhancement was calculated for each temporomandibular joint using 3 different types of equations termed normalization ratios. The enhancement profiles generated by each equation were studied to determine which provided the best discrimination between affected and unaffected joints, was the least susceptible to sampling errors, and was the most clinically feasible. A ratio of synovial enhancement (defined as the difference between the postgadolinium and the pregadolinium T1 signal of the synovium) to the postgadolinium signal of the longus capitis provided the best discrimination between affected and unaffected joints, the least susceptibility to sampling error, and was thought to be the most clinically feasible method of quantification of synovial inflammation. Additional synovial enhancement ratios studied did not provide the same level rates of discrimination between the affected and unaffected joints and were thought to be too temporally variable to provide reliable clinical use. We provide a robust, reproducible, dynamic gadolinium-enhanced MR imaging technique for the quantitative assessment of temporomandibular joint synovitis in patients with juvenile idiopathic arthritis.
ISSN:0195-6108
1936-959X
DOI:10.3174/ajnr.A5424