Magnetic resonance spin-labeling perfusion imaging of synovitis in inflammatory arthritis at 3.0 T

Abstract

Objective: The aim of this study was to test the feasibility of arterial spin labeling (ASL) perfusion imaging of synovitis in inflammatory joint diseases on a clinical 3.0 T whole-body scanner.

Materials and methods: Fifteen patients (geometric mean 47 years, range 8-69 years) with different types of inflammatory arthritis of the finger or wrist joints participated in the study. In addition to conventional spin-echo and dynamic contrast-enhanced FLASH3D sequences, a novel spin-labeling technique (FAIR-TrueFISP) for quantitative assessment of tissue perfusion was applied. Perfusion maps were calculated pixel-wise by means of the extended Bloch equations.

Results: Perfusion maps showed good image quality with clear visualization of hyperaemia in synovitis. The computed perfusion maps corresponded best to subtraction images of the dynamic series from 30 to 60 s after contrast-medium injection. The quantitative perfusion values of synovitis showed a good correlation with the disease activity. Perfusion values for inflamed synovium in phase of high activity were up to 230 ml/100 g tissue/min.

Conclusion: The proposed modality allows for the assessment of disease activity in arthritis without the application of contrast-medium offering a new tool for therapy monitoring. As the technique provides quantitative information on hyperaemia, it potentially offers new insights in the pathophysiology of arthritic diseases.