Diffusion-weighted MRI of bone marrow oedema, soft tissue oedema and synovitis in paediatric patients: feasibility and initial experience

<p>Abstract</p> <p>Background</p> <p>MRI has become the mainstay of diagnostic imaging in paediatric rheumatology for lesion detection, differential diagnosis and therapy surveillance. MR imaging of synovitis, in particular, is indispensable for early diagnosis and foll...

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Main Authors: Neubauer Henning, Evangelista Laura, Morbach Henner, Girschick Hermann, Prelog Martina, Köstler Herbert, Hahn Dietbert, Beer Meinrad
Format: Article
Language:English
Published: BMC 2012-07-01
Series:Pediatric Rheumatology Online Journal
Online Access:http://www.ped-rheum.com/content/10/1/20
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author Neubauer Henning
Evangelista Laura
Morbach Henner
Girschick Hermann
Prelog Martina
Köstler Herbert
Hahn Dietbert
Beer Meinrad
author_facet Neubauer Henning
Evangelista Laura
Morbach Henner
Girschick Hermann
Prelog Martina
Köstler Herbert
Hahn Dietbert
Beer Meinrad
author_sort Neubauer Henning
collection DOAJ
description <p>Abstract</p> <p>Background</p> <p>MRI has become the mainstay of diagnostic imaging in paediatric rheumatology for lesion detection, differential diagnosis and therapy surveillance. MR imaging of synovitis, in particular, is indispensable for early diagnosis and follow-up in arthritis patients. We used diffusion-weighted MRI (DWI) as a new imaging modality in comparison to standard MRI sequences to study bone marrow oedema, soft-tissue oedema and synovitis in paediatric patients.</p> <p>Methods</p> <p>A total of 52 patients (mean age 11 ± 5 years) with bone marrow oedema (n = 31), soft-tissue oedema (n = 20) and synovitis (n = 15) were examined with transversal diffusion-weighted single-shot echoplanar imaging in addition to standard MR sequences (T2W TIRM, T1W pre- and post-contrast). Diffusion-weighted images were used for lesion detection and apparent diffusion coefficient (ADC, unit × 10<sup>-3</sup> mm<sup>2</sup>/s) values were measured with ROI technique on ADC maps.</p> <p>Results</p> <p>In 50 of 52 patients, DWI delineated the lesion of interest corresponding to pathological signal increase on standard sequences. Mean ADC was 1.60 ± 0.14 (range 1.38 - 1.99) in osseous lesions, 1.72 ± 0.31 (range 1.43 - 2.56) in soft tissue oedema and 2.82 ± 0.24 (range 2.47 - 3.18) for joint effusion (ANOVA p < 0.001). No significant difference in mean ADC was seen for inflammatory vs. non-inflammatory lesions. Relative signal intensity of oedema was similar for DWI and T2W TIRM. DWI visualised synovial restricted diffusion with a mean ADC of 2.12 ± 0.45 in 12 of 15 patients with synovitis.</p> <p>Conclusions</p> <p>Diffusion-weighted MRI reliably visualises osseous and soft tissue oedema, as compared to standard sequences. DWI of synovitis is feasible in large joints and presents a novel approach to contrast-free imaging of synovitis. Whole-body DWI for chronic non-bacterial osteomyelitis should be evaluated in future studies.</p>
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spelling doaj.art-81b74a6d41a949bdaaf8690a30c3ec9b2022-12-21T21:05:13ZengBMCPediatric Rheumatology Online Journal1546-00962012-07-011012010.1186/1546-0096-10-20Diffusion-weighted MRI of bone marrow oedema, soft tissue oedema and synovitis in paediatric patients: feasibility and initial experienceNeubauer HenningEvangelista LauraMorbach HennerGirschick HermannPrelog MartinaKöstler HerbertHahn DietbertBeer Meinrad<p>Abstract</p> <p>Background</p> <p>MRI has become the mainstay of diagnostic imaging in paediatric rheumatology for lesion detection, differential diagnosis and therapy surveillance. MR imaging of synovitis, in particular, is indispensable for early diagnosis and follow-up in arthritis patients. We used diffusion-weighted MRI (DWI) as a new imaging modality in comparison to standard MRI sequences to study bone marrow oedema, soft-tissue oedema and synovitis in paediatric patients.</p> <p>Methods</p> <p>A total of 52 patients (mean age 11 ± 5 years) with bone marrow oedema (n = 31), soft-tissue oedema (n = 20) and synovitis (n = 15) were examined with transversal diffusion-weighted single-shot echoplanar imaging in addition to standard MR sequences (T2W TIRM, T1W pre- and post-contrast). Diffusion-weighted images were used for lesion detection and apparent diffusion coefficient (ADC, unit × 10<sup>-3</sup> mm<sup>2</sup>/s) values were measured with ROI technique on ADC maps.</p> <p>Results</p> <p>In 50 of 52 patients, DWI delineated the lesion of interest corresponding to pathological signal increase on standard sequences. Mean ADC was 1.60 ± 0.14 (range 1.38 - 1.99) in osseous lesions, 1.72 ± 0.31 (range 1.43 - 2.56) in soft tissue oedema and 2.82 ± 0.24 (range 2.47 - 3.18) for joint effusion (ANOVA p < 0.001). No significant difference in mean ADC was seen for inflammatory vs. non-inflammatory lesions. Relative signal intensity of oedema was similar for DWI and T2W TIRM. DWI visualised synovial restricted diffusion with a mean ADC of 2.12 ± 0.45 in 12 of 15 patients with synovitis.</p> <p>Conclusions</p> <p>Diffusion-weighted MRI reliably visualises osseous and soft tissue oedema, as compared to standard sequences. DWI of synovitis is feasible in large joints and presents a novel approach to contrast-free imaging of synovitis. Whole-body DWI for chronic non-bacterial osteomyelitis should be evaluated in future studies.</p>http://www.ped-rheum.com/content/10/1/20
spellingShingle Neubauer Henning
Evangelista Laura
Morbach Henner
Girschick Hermann
Prelog Martina
Köstler Herbert
Hahn Dietbert
Beer Meinrad
Diffusion-weighted MRI of bone marrow oedema, soft tissue oedema and synovitis in paediatric patients: feasibility and initial experience
Pediatric Rheumatology Online Journal
title Diffusion-weighted MRI of bone marrow oedema, soft tissue oedema and synovitis in paediatric patients: feasibility and initial experience
title_full Diffusion-weighted MRI of bone marrow oedema, soft tissue oedema and synovitis in paediatric patients: feasibility and initial experience
title_fullStr Diffusion-weighted MRI of bone marrow oedema, soft tissue oedema and synovitis in paediatric patients: feasibility and initial experience
title_full_unstemmed Diffusion-weighted MRI of bone marrow oedema, soft tissue oedema and synovitis in paediatric patients: feasibility and initial experience
title_short Diffusion-weighted MRI of bone marrow oedema, soft tissue oedema and synovitis in paediatric patients: feasibility and initial experience
title_sort diffusion weighted mri of bone marrow oedema soft tissue oedema and synovitis in paediatric patients feasibility and initial experience
url http://www.ped-rheum.com/content/10/1/20
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