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Magnetic resonance imaging of the wrist in defining remission of rheumatoid arthritis

 Lee J  ;  Lee SK  ;  Suh JS  ;  Yoon M  ;  Song JH  ;  Lee CH 
 JOURNAL OF RHEUMATOLOGY, Vol.24(7) : 1303-1308, 1997 
Journal Title
Issue Date
Adult ; Antirheumatic Agents/administration & dosage ; Arthritis, Rheumatoid/diagnosis* ; Arthritis, Rheumatoid/drug therapy* ; Arthritis, Rheumatoid/pathology ; Contrast Media ; Evaluation Studies as Topic ; Female ; Gadolinium DTPA ; Humans ; Hydroxychloroquine/administration & dosage ; Magnetic Resonance Imaging* ; Male ; Methotrexate/administration & dosage ; Middle Aged ; Organometallic Compounds ; Pentetic Acid/analogs & derivatives ; Remission Induction ; Remission, Spontaneous ; Wrist/pathology*
OBJECTIVE: To assess the efficacy of magnetic resonance imaging (MRI) in objectively defining a state of remission in rheumatoid arthritis (RA) after treatment. METHODS: Ten patients with RA involving the wrist were evaluated before treatment with methotrexate and hydroxychloroquine, and then mean 14 mo later with a followup evaluation. Clinical variables, laboratory measurements, and MRI using various techniques (T1 weighted image, T2 weighted image, fat suppression T2 weighted image, postcontrast T1 weighted image, postcontrast dynamic image, postcontrast 3 dimensional image) were observed. Remission was defined by ACR criteria. MRI changes were observed using 3 variables: extent of synovial proliferation; extent of bone marrow edema; and development of new erosion. In 6 of 10 patients, synovial signal intensity time curve changes at 30 s (E30 ratio) were determined for quantitative assessment of synovitis. RESULTS: Four patients achieved remission and 6 did not. All patients in remission showed decrease in extent of synovial proliferation and bone marrow edema with no newly developed erosion after treatment, compared to baseline. Five of 6 patients in nonremission showed newly developed erosions with variable changes in extent of synovial proliferation and bone marrow edema. E30 ratio was determined in 3 patients in the remission group and 3 in the nonremission group, with 48% reduction in the former compared to 9% reduction in the latter. CONCLUSION: MRI is feasible for objectively defining remission and assessing the therapeutic effect of antirheumatic drugs; utility of MRI measures in clinical remission criteria remains to be verified.
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Radiology (영상의학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Nuclear Medicine (핵의학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Suh, Jin Suck(서진석) ORCID logo https://orcid.org/0000-0001-9455-9240
Yun, Mi Jin(윤미진) ORCID logo https://orcid.org/0000-0002-1712-163X
Lee, Soo Kon(이수곤)
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