MRI In Knee Of Juvenile Idiopathic Arthritis

Objective Research on Diagnostic Value of Knee-Joint MRI of Juvenile Idiopathic Arthritis Patients.Materials and Methods Collect 24 children clinically diagnosed with Juvenile idiopathic arthritis showing symptoms such as keen pain and swelling as research objects. First make an X-ray radiograph test to them, and then make a plain scan and an enhanced scan to the suffering knees with a 3.OT magnetic resonance on the same day. The scanning coil is a 3.0T knee-joint coil. The MRI plain scan sequence includes a coronal-view T1WI scan, a coronal-view and sagittal-view T2WI scan and a sagittal-view T2WI fat-suppression sequence; a enhanced scan of cubital vein injected contrast Gadopentetate dimeglumine (Gd-DTPA 0.1 ml/kg), and a sagittal & transverse-view T1WI fat-suppression sequence scan. Among 24 cases in the group,17 cases went through a plain scan and enhanced scan at the same time, and 7 cases only went through a plain scan. The T2WI fat-suppression sequence plain scan is used for observing and calculating the hydrops in suprapatellar bursa of suffering keens; the T2WI fat-suppression sequence enhanced scan is used for observing the synovium thickness of suprapatellar bursa of suffering keens. Observe MRI expression of synovium thickness of involved knees, hydrops of joint capsule, bone marrow edema and cartilaginous articular surface injuries of early juvenile idiopathic arthritis (JIA). Compare positive characteristics of suffering knees of JIA got through MRI and X-ray in terms of sensitivity and specificity. Meanwhile, collect clinical data of patients. Using a SPSS 13.0 statistical software and a method of bivariate linear correlation to analyze the correlation between quantitative measurement results such as suprapatellar bursa synovium and suprapatellar bursa articular cavity hydrops of suffering knees, and patients’clinical data such as pain degree, rheumatoid factor, red blood cell sedimentation rate, C reactive protein titer and different activity stages of disease.Result In the JIA group of the research,24 cases all went through a MRI scan and an X-ray radiograph, among which 17 cases also went through a MRI enhanced scan at the same time, and 7 cases only went through MRI plain scan for patient reasons. Through the X-ray radiograph, we only find that involved knees are swelling, but no obvious bone destruction is found.24 cases under MRI plain scan all show suprapatellar bursa by drops; 17 cases under enhanced scan all show thickening of suprapatellar bursa synovium of varying degrees; 11 cases show pannus; 5 cases have bone marrow edema; 4 cases have cartilaginous articular surface injuries and degeneration; 2 cases have cruciate ligament injuries; 1 case has popliteal lymphadenectasis. The measured volumetric value of suprapatellar bursa synovium is 4.14±2.11cm3; the measured thickness value of the thickest-lay suprapatellar bursa synovium is 3.21±1.27mm; the measured value of suprapatellar bursa hydrops is 13.19±5.44ml. The Pearson correlation analysis points out that the correlation between suprapatellar bursa hydrops and the thickness of the thickest-lay suprapatellar bursa synovium of suffering knees has significance.The correlations between suprapatellar bursa hydrops and the thickness of the thickest-lay suprapatellar bursa synovium, and the clinical serological test results (RF、ESR) and different activity stages of the disease have significance respectively, but their correlations with CRP have no significance.Conclusion MRI can sensitively and accurately show knees’pathological changes of early JIA patients, such as synovium hypertrophy, pannus, bone marrow edema, cartilaginous articular surface injuries and hydrops of joint capsule. Through the quantitative measurement on MRI symptom of JIA, we can assess the inflammation activity and disease degree of JIA lesion; through the quantitative measurement on synovium and hydrops, we can determine different activity stages of the disease. In this way, they can provide a imaging basis for early clinical diagnosis and treatment effect assessment of JIA.