Dynamic Contrast-Enhanced MRI In Serological Negative Early Stage Rheumatoid Arthritis Compared With Osteoarthritis In Hand And Evaluate The Activity In Rheumatoid Arthritis

Objective : Part one: To investigate the value of dynamic contrast-enhanced magnetic resonance imaging in differentiating hand synovitis between serological negative early stage rheumatoid arthritis (RA) and osteoarthritis (OA). Part two:To study the value of dynamic contrast-enhanced magnetic resonance imaging in evaluating the activity of early stage RA.Material and Methods: Plain MRI, enhanced MRI of whole hand and Dynamic contrast-enhanced MRI(DCE-MRI) of single slice were perfermed in 53 patients of suspected RA or OA and 18 healthy volunteers. 23 of them were diagnosed as RA (include 18 cases of serological negative), 18 cases of them were diagnosed as OA after 3 to 6 months follow-up.The contrast rate and volume of synovial membrane were compared among three groups using rank sum test and variance analysis.MRI signs of RA and OA group were evaluated and calculated with rank sum test. Also the contrast rate and volume of synovial membrane were compared between 9 cases of actived RA and 9 cases of inactived RA with rank sum test and t-test. MRI score (RAMRIS) of RA and Desease Activity Score 28(DAS28) were calculated. RAMRIS with DAS28, the contrast rate of synovial membrane with DAS28 and the synovial membrane volume with DAS28 were compared using correlation analysis.Results: (1) The dynamic contrast rate of RA group was significantly higher than that of OA group(P<0.005) and the dynamic contrast rate of OA group was significantly higher than that of control group (P<0.005). (2) Dynamic contrast rate of actived RA group was significantly higher than that of inactived RA group (P<0.005). (3)The synovial membrane volume of RA group and OA group was significantly higher than that of control group (P<0.005). There was statistical difference of the synovial membrane volume between the RA group and OA group. There was statistical difference of the synovial membrane volume between the actived RA group statistical difference of the synovial membrane volume between the actived RA group and the inactived RA group(P<0.005).(4)The RAMRIS, the dynamic contrast rate and the synovial membrane volume is positive correlation with the DAS28.Conclusion: (1) The contrast rate and the synovial membrane volume may provide useful information that can help differentiate OA synovitis from serological negative early stage RA.(2) Dynamic Contrast-Enhanced MRI and RAMRIS can provide useful information to evaluate the activity degree and the pathology phase of RA. (3) Many signs of MRI can help differentiate OA synovitis from RA.