Magnetic resonance imaging in inflammatory rheumatoid diseases

Abstract

Magnetic resonance (MR) is used more and more frequently to diagnose changes in the musculoskeletal system in the course of rheumatic diseases, at their initial assessment, for treatment monitoring and for identification of complications. The article presents the history of magnetic resonance imaging, the basic principles underlying its operation as well as types of magnets, coils and MRI protocols used in the diagnostic process of rheumatic diseases. It enumerates advantages and disadvantages of individual MRI scanners. The principles of MRI coil operation are explained, and the sequences used for MR image analysis are described, particularly in terms of their application in rheumatology, including T1-, T2-, PD-weighted, STIR/TIRM and contrast-enhanced T1-weighted images. Furthermore, views on the need to use contrast agents to optimise diagnosis, particularly in synovitis-like changes, are presented. Finally, methods for the assessment of MR images are listed, including the semi-quantitative method by RAMRIS and quantitative dynamic examination.

The application value of MRI in the diagnosis of subclinical inflammation in patients with rheumatoid arthritis in remission

“…In addition, ultrasound examination is economical and convenient; however, it reduces the reliability of the assessment of the disease activity, due to high sensitivity to synovitis and early bone erosion, is highly dependent on the doctor’s experience, and cannot evaluate the bone marrow edema [ 16 ]. Therefore, MRI is the most reliable imaging examination of the early RA [ 17 ].…”

Implementation of artificial intelligence models in magnetic resonance imaging with focus on diagnosis of rheumatoid arthritis and axial spondyloarthritis: narrative review

“…T1-Weighted (T1W) sequences are very useful because they have a short acquisition time, provide concise anatomical details (bone erosions have low signal on T1W images) and can also highlight inflammation after the administration of the contrast agent ( 35 ). On the TW sequences, the fat tissue and the soft tissue highlighted by the administration of the contrast substance displays a strong signal.…”

“…Because gadolinium (Gd) uptake is influenced by tissue vascularity and perfusion, the inflamed synovium, which is highly vascularized and perfused, becomes clearly visible. In T1W with fat saturation (FS) postcontrast acquisitions, FS allows the differentiation between the inflamed synovial membrane and the adjacent tissues ( 35 , 36 ), thus making possible the easy recognition of the inflammatory process ( 35 ).…”

“…T2-Weighted (T2W) sequences allow the visualization of features such as BME, fluid ( Figure 4 ) as well as fat tissue, while T2W FS sequence is very useful in differentiating BME from lipomatous degeneration of bone structures ( 35 , 36 ).…”

Magnetresonanztomografie peripherer Gelenke

“…Grundsätzlich können rheumatische Gelenkerkrankungen am Hochfeld-MRT (HF-MRT, in der Regel 1,5-3 Tesla, [T]) oder am Niederfeld-MRT (NF-MRT, 0,2 T) abgeklärt werden [13,14]. Im Allgemeinen wird das HF-MRT mit seiner sehr hohen Ortsauflösung und einem exzellenten Signal-zu-Rausch-Verhältnis (SNR) dem NF-MRT vorgezogen [15]. Insbesondere für die Erfassung von Knochenmarködemen hat sich das HF-MRT gegenüber dem NF-MRT als überlegen herausgestellt [16].…”