Download PDF
Arthritis und Rheuma 2020; 40(03): 163-172
DOI: 10.1055/a-1161-5922
Schwerpunkt
© Georg Thieme Verlag KG Stuttgart · New York

Magnetresonanztomografie peripherer Gelenke

Update 2020Magnetic Resonance Imaging of peripheral jointsUpdate 2020
Daniel B. Abrar∗
1   Institut für Diagnostische und Interventionelle Radiologie, Heinrich-Heine-Universität Düsseldorf
,
Philipp Sewerin∗
2   Poliklinik, Funktionsbereich und Hiller Forschungszentrum für Rheumatologie, Heinrich-Heine-Universität Düsseldorf
› Author Affiliations
Further Information

Publication History

Publication Date:
16 June 2020 (online)

    Permissions and Reprints

ZUSAMMENFASSUNG

Bildgebende Verfahren nehmen in der Primärdiagnostik, Prognose und Therapiekontrolle einen zunehmenden Stellenwert ein. Insbesondere die Magnetresonanztomografie (MRT) ermöglicht dabei die sensitive und frühe Erkennung akut-entzündlicher (z. B. Synovialitis und Knochenmarködem) und chronisch-struktureller (z. B. Erosionen) Veränderungen im Rahmen peripherer rheumatischer Gelenkerkrankungen. Die steigende Bedeutung wird durch die Etablierung standardisierter, zunehmend vereinfachter Scoring-Systeme unterstrichen, die MRT-Untersuchungen objektivier- und vergleichbar machen. Zudem wird durch den Einsatz innovativer, kompositioneller Methoden die Früherkennung von Knorpelveränderungen und durch dynamische Verfahren die Quantifizierung fokaler Gelenkentzündung ermöglicht.

ABSTRACT

Imaging procedures are becoming increasingly important in the primary diagnosis, outcome prediction and therapy monitoring. Magnetic resonance imaging (MRI) enables the sensitive and early detection of acute-inflammatory (e. g. synovitis and bone marrow edema) and chronic-structural (e. g. erosions) changes in peripheral rheumatic joint diseases. The increasing importance is underlined by the establishment of standardized and increasingly simplified scoring systems, which make MRI examinations more objective and comparable. In addition, the use of innovative, compositional methods enables the early detection of cartilage changes. Further, dynamic procedures allow the quantification of focal joint inflammation.

Schlüsselwörter

Bildgebung - MRT - rheumatoide Arthritis - Psoriasis-Arthritis

Keywords

Imaging - MRI - rheumatoid arthritis - psoriatic arthritis
 

  • Literatur

  • 1 Smolen JS, Landewé RBM, Bijlsma JWJ. et al EULAR recommendations for the management of rheumatoid arthritis with synthetic and biological disease-modifying antirheumatic drugs: 2019 update. Ann Rheum Dis 2020
    PubMedGoogle Scholar
  • 2 Colebatch AN, Edwards CJ, Østergaard M. et al EULAR recommendations for the use of imaging of the joints in the clinical management of rheumatoid arthritis. Ann Rheum Dis 2013; 72 (06) 804-814
    CrossrefPubMedGoogle Scholar
  • 3 Merola JF, Espinoza LR, Fleischmann R.. Distinguishing rheumatoid arthritis from psoriatic arthritis. RMD Open 2018; 4 (02) e000656 (accessed 25 Feb 2020)
    CrossrefPubMedGoogle Scholar
  • 4 Østergaard M, McQueen F, Wiell C. et al The OMERACT psoriatic arthritis magnetic resonance imaging scoring system (PsAMRIS): definitions of key pathologies, suggested MRI sequences, and preliminary scoring system for PsA Hands. J Rheumatol 2009; 36 (08) 1816-1824
    Google Scholar
  • 5 Østergaard M, Bird P, Gandjbakhch F. et al The OMERACT MRI in Arthritis Working Group – Update on Status and Future Research Priorities. J Rheumatol 2015; 42 (12) 2470-2472
    Google Scholar
  • 6 Østergaard M, Peterfy CG, Bird P. et al The OMERACT Rheumatoid Arthritis Magnetic Resonance Imaging (MRI) Scoring System: Updated Recommendations by the OMERACT MRI in Arthritis Working Group. J Rheumatol 2017; 44 (11) 1706-1712
    CrossrefPubMedGoogle Scholar
  • 7 Radbruch A.. Gadolinium Deposition in the Brain: We Need to Differentiate between Chelated and Dechelated Gadolinium. Radiology 2018; 288 (02) 434-435
    CrossrefPubMedGoogle Scholar
  • 8 Radbruch A, Richter H, Fingerhut S. et al Gadolinium Deposition in the Brain in a Large Animal Model: Comparison of Linear and Macrocyclic Gadolinium-Based Contrast Agents. Invest Radiol 2019; 54 (09) 531-536
    CrossrefPubMedGoogle Scholar
  • 9 Radbruch A, Weberling LD, Kieslich PJ. et al High-Signal Intensity in the Dentate Nucleus and Globus Pallidus on Unenhanced T1-Weighted Images: Evaluation of the Macrocyclic Gadolinium-Based Contrast Agent Gadobutrol. Invest Radiol 2015; 50 (12) 805-810
    CrossrefPubMedGoogle Scholar
  • 10 Quattrocchi CC, Ramalho J, van der Molen AJ. et al Standardized assessment of the signal intensity increase on unenhanced T1-weighted images in the brain: the European Gadolinium Retention Evaluation Consortium (GREC) Task Force position statement. Eur Radiol 2019; 29 (08) 3959-3967
    CrossrefPubMedGoogle Scholar
  • 11 Dekkers IA, Roos R, van der Molen AJ.. Gadolinium retention after administration of contrast agents based on linear chelators and the recommendations of the European Medicines Agency. Eur Radiol 2018; 28 (04) 1579-1584
    CrossrefPubMedGoogle Scholar
  • 12 Cowling T, Frey N.. Macrocyclic and Linear Gadolinium Based Contrast Agents for Adults Undergoing Magnetic Resonance Imaging: A Review of Safety. Ottawa (ON): 2019
    Google Scholar
  • 13 Ostendorf B, Edelmann E, Kellner H. et al Niederfeldmagnetresonanztomographie bei rheumatoider Arthritis. Z Rheumatol 2010; 69 (01) 79-86
    CrossrefPubMedGoogle Scholar
  • 14 Ostendorf B, Scherer A, Backhaus M. et al Bildgebende Verfahren in der Rheumatologie: Magnetresonanztomographie bei Rheumatoider Arthritis. Z Rheumatol 2003; 62 (03) 274-286
    CrossrefPubMedGoogle Scholar
  • 15 Sudoł-Szopińska I, Mróz J, Ostrowska M. et al Magnetic resonance imaging in inflammatory rheumatoid diseases. Reumatologia 2016; 54 (04) 170-176
    PubMedGoogle Scholar
  • 16 Extremity magnetic resonance imaging in rheumatoid arthritis: report of the American College of Rheumatology Extremity Magnetic Resonance Imaging Task Force. Arthritis Rheum 2006; 54 (04) 1034-1047
    CrossrefPubMedGoogle Scholar
  • 17 Ejbjerg BJ, Narvestad E, Jacobsen S. et al Optimised, low cost, low field dedicated extremity MRI is highly specific and sensitive for synovitis and bone erosions in rheumatoid arthritis wrist and finger joints: comparison with conventional high field MRI and radiography. Ann Rheum Dis 2005; 64 (09) 1280-1287
    CrossrefPubMedGoogle Scholar
  • 18 Feletar M, Hall S, Bird P.. Evaluation of Magnetic Resonance Imaging Responsiveness in Active Psoriatic Arthritis at Multiple Timepoints during the First 12 Weeks of Antitumor Necrosis Factor Therapy. J Rheumatol 2016; 43 (01) 75-80
    Google Scholar
  • 19 Hirota T, Suzuki T, Ogishima H. et al Evaluation of changes in magnetic resonance images following 24 and 52 weeks of treatment of rheumatoid arthritis with infliximab, tocilizumab, or abatacept. Mod Rheumatol 2016; 26 (01) 29-35
    CrossrefPubMedGoogle Scholar
  • 20 Sewerin P, Vordenbaeumen S, Hoyer A. et al Silent progression in patients with rheumatoid arthritis: is DAS28 remission an insufficient goal in RA? Results from the German Remission-plus cohort. BMC Musculoskelet Disord 2017; 18 (01) 163
    CrossrefPubMedGoogle Scholar
  • 21 Kwok WE, You Z, Monu J. et al High-resolution uniform MR imaging of finger joints using a dedicated RF coil at 3 T. J Magn Reson Imaging 2010; 31 (01) 240-247
    CrossrefPubMedGoogle Scholar
  • 22 Østergaard M, Peterfy C, Conaghan P. et al OMERACT Rheumatoid Arthritis Magnetic Resonance Imaging Studies. Core set of MRI acquisitions, joint pathology definitions, and the OMERACT RA-MRI scoring system. J Rheumatol 2003; 30 (06) 1385-1386
    Google Scholar
  • 23 Frenken M, Schleich C, Brinks R. et al The value of the simplified RAMRIS-5 in early RA patients under methotrexate therapy using high-field MRI. Arthritis Res Ther 2019; 21 (01) 21
    CrossrefPubMedGoogle Scholar
  • 24 Schett G, Gravallese E.. Bone erosion in rheumatoid arthritis: mechanisms, diagnosis and treatment. Nat Rev Rheumatol 2012; 8 (11) 656-664 (accessed 25 Feb 2020)
    CrossrefPubMedGoogle Scholar
  • 25 Sudoł-Szopińska I, Jans L, Teh J.. Rheumatoid arthritis: what do MRI and ultrasound show. J Ultrason 2017; 17 (68) 5-16 (accessed 25 Feb 2020)
    CrossrefPubMedGoogle Scholar
  • 26 Eriksen EF.. Treatment of bone marrow lesions (bone marrow edema). Bonekey Rep 2015; 4: 755 https://link.springer.com/content/pdf/10.1007/s40257-018-0377-2.pdf (accessed 25 Feb 2020)
    CrossrefPubMedGoogle Scholar
  • 27 Gandjbakhch F, Foltz V, Mallet A. et al Bone marrow oedema predicts structural progression in a 1-year follow-up of 85 patients with RA in remission or with low disease activity with low-field MRI. Ann Rheum Dis 2011; 70 (12) 2159-2162
    CrossrefPubMedGoogle Scholar
  • 28 McQueen FM, Ostendorf B.. What is MRI bone oedema in rheumatoid arthritis and why does it matter?. Arthritis Res Ther 2006; 8 (06) 222
    CrossrefPubMedGoogle Scholar
  • 29 Baker JF, Østergaard M, Emery P. et al Early MRI measures independently predict 1-year and 2-year radiographic progression in rheumatoid arthritis: secondary analysis from a large clinical trial. Ann Rheum Dis 2014; 73 (11) 1968-1974
    CrossrefPubMedGoogle Scholar
  • 30 Simon D, Kleyer A, Faustini F. et al Simultaneous quantification of bone erosions and enthesiophytes in the joints of patients with psoriasis or psoriatic arthritis – effects of age and disease duration. Arthritis Res Ther 2018; 20 (01) 203 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5974634/pdf/RU-56-32710.pdf (accessed 25 Feb 2020)
    CrossrefPubMedGoogle Scholar
  • 31 Paine A, Ritchlin C.. Altered Bone Remodeling in Psoriatic Disease: New Insights and Future Directions. Calcif Tissue Int 2018; 102 (05) 559-574 (accessed 25 Feb 2020)
    CrossrefPubMedGoogle Scholar
  • 32 Kaeley GS, Eder L, Aydin SZ. et al Dactylitis: A hallmark of psoriatic arthritis. Semin Arthritis Rheum 2018; 48 (02) 263-273
    CrossrefPubMedGoogle Scholar
  • 33 Sunar I, Ataman S, Nas K. et al Enthesitis and its relationship with disease activity, functional status, and quality of life in psoriatic arthritis: a multi-center study. Rheumatol Int 2020; 40 (02) 283-294
    CrossrefPubMedGoogle Scholar
  • 34 Kaeley GS, Eder L, Aydin SZ. et al Enthesitis: A hallmark of psoriatic arthritis. Semin Arthritis Rheum 2018; 48 (01) 35-43
    CrossrefPubMedGoogle Scholar
  • 35 Tan AL, Fukuba E, Halliday NA. et al High-resolution MRI assessment of dactylitis in psoriatic arthritis shows flexor tendon pulley and sheath-related enthesitis. Ann Rheum Dis 2015; 74 (01) 185-189
    CrossrefPubMedGoogle Scholar
  • 36 Tinazzi I, McGonagle D, Aydin SZ. et al ‘Deep Koebner’ phenomenon of the flexor tendon-associated accessory pulleys as a novel factor in tenosynovitis and dactylitis in psoriatic arthritis. Ann Rheum Dis 2018; 77 (06) 922-925
    CrossrefPubMedGoogle Scholar
  • 37 Bagel J, Schwartzman S.. Enthesitis and Dactylitis in Psoriatic Disease: A Guide for Dermatologists. Am J Clin Dermatol 2018; 19 (06) 839-852 (accessed 25 Feb 2020)
    CrossrefPubMedGoogle Scholar
  • 38 Fuchs J, Rabenberg M, Scheidt-Nave C.. Prävalenz ausgewählter muskuloskelettaler Erkrankungen: Ergebnisse der Studie zur Gesundheit Erwachsener in Deutschland (DEGS1). Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2013; 56 5–6 678-686
    CrossrefPubMedGoogle Scholar
  • 39 Sewerin P, Brinks R, Schneider M. et al Prevalence and incidence of psoriasis and psoriatic arthritis. Ann Rheum Dis 2019; 78 (02) 286-287
    CrossrefPubMedGoogle Scholar
  • 40 Ostrowska M, Maśliński W, Prochorec-Sobieszek M. et al Cartilage and bone damage in rheumatoid arthritis. Reumatologia 2018; 56 (02) 111-120 (accessed 27 Feb 2020)
    CrossrefPubMedGoogle Scholar
  • 41 Hayer S, Bauer G, Willburger M. et al Cartilage damage and bone erosion are more prominent determinants of functional impairment in longstanding experimental arthritis than synovial inflammation. Dis Model Mech 2016; 9 (11) 1329-1338 https://link.springer.com/content/pdf/10.1007/s40134-014-0060-1.pdf
    CrossrefPubMedGoogle Scholar
  • 42 Guermazi A, Alizai H, Crema MD. et al Compositional MRI techniques for evaluation of cartilage degeneration in osteoarthritis. Osteoarthr Cartil 2015; 23 (10) 1639-1653
    CrossrefPubMedGoogle Scholar
  • 43 Schleich C, Bittersohl B, Miese F. et al Glycosaminoglycan chemical exchange saturation transfer at 3 T MRI in asymptomatic knee joints. Acta Radiol 2016; 57 (05) 627-632
    CrossrefPubMedGoogle Scholar
  • 44 Pulickal T, Boos J, Konieczny M. et al MRI identifies biochemical alterations of intervertebral discs in patients with low back pain and radiculopathy. Eur Radiol 2019; 29 (12) 6443-6446
    CrossrefPubMedGoogle Scholar
  • 45 Kogan F, Hargreaves BA, Gold GE.. Volumetric multislice gagCEST imaging of articular cartilage: Optimization and comparison with T1rho. Magn Reson Med 2017; 77 (03) 1134-1141
    CrossrefPubMedGoogle Scholar
  • 46 Brinkhof S, Ali Haghnejad A, Ito K. et al Uncompromised MRI of knee cartilage while incorporating sensitive sodium MRI. NMR Biomed 2019; 32 (11) e4173
    PubMedGoogle Scholar
  • 47 Vordenbäumen S, Schleich C, Lögters T. et al Dynamic contrast-enhanced magnetic resonance imaging of metacarpophalangeal joints reflects histological signs of synovitis in rheumatoid arthritis. Arthritis Res Ther 2014; 16 (05) 452
    CrossrefPubMedGoogle Scholar
  • 48 Müller-Lutz A, Schleich C, Sewerin P. et al Comparison of quantitative and semiquantitative dynamic contrast-enhanced MRI with respect to their correlation to delayed gadolinium-enhanced MRI of the cartilage in patients with early rheumatoid arthritis. J Comput Assist Tomogr 2015; 39 (01) 64-69
    CrossrefPubMedGoogle Scholar
  • 49 Baraliakos X, Kleyer A, Simon D. et al Bildgebung bei der Psoriasisarthritis und Aspekte der röntgenologischen Progression. Z Rheumatol 2020; 79 (01) 40-52
    CrossrefPubMedGoogle Scholar
  • 50 Ritchlin CT, Colbert RA, Gladman DD.. Psoriatic Arthritis. N Engl J Med 2017; 376 (21) 2095-2096
    PubMedGoogle Scholar
  • 51 McGonagle D, Hermann K-GA, Tan AL.. Differentiation between osteoarthritis and psoriatic arthritis: implications for pathogenesis and treatment in the biologic therapy era. Rheumatology (Oxford) 2015; 54 (01) 29-38
    CrossrefPubMedGoogle Scholar
  • 52 Braum LS, McGonagle D, Bruns A. et al Characterisation of hand small joints arthropathy using high-resolution MRI--limited discrimination between osteoarthritis and psoriatic arthritis. Eur Radiol 2013; 23 (06) 1686-1693
    CrossrefPubMedGoogle Scholar