COMPARISON OF THE EFFICACY OF CONTRAST-ENHANCED ULTRASONOGRAPHY (US) AND MAGNETIC RESONANCE IMAGING (MRI) IN DETECTING SYNOVIAL PROCESS IN PATIENTS WITH KNEE OSTEOARTHRITIS COMPARED TO HEALTHY CONTROLS
[2007] [SAT0465] COMPARISON OF THE
EFFICACY OF CONTRAST-ENHANCED ULTRASONOGRAPHY (US) AND MAGNETIC RESONANCE
IMAGING (MRI) IN DETECTING SYNOVIAL PROCESS IN PATIENTS WITH KNEE
OSTEOARTHRITIS COMPARED TO HEALTHY CONTROLS
I. Song 1, C.
Althoff 2, K. Hermann 2, A. Scheel 3, C.
Werner 4, T. Knetsch 5, M. Schoenharting 6, G.
Burmester 1, M. Backhaus 1 1Rheumatology, 2Radiology,
Universitaetsmedizin Berlin, Charite Campus Mitte, Berlin, 3Nephrology/Rheumatology,
4Medical Statistics, University Hospital Goettingen, Goettingen, 5Esaote,
University Hospital Goettingen, Neufahrn, 6Sanofi-Aventis,
University Hospital Goettingen, Frankfurt a.M., Germany
Background: In osteoarthritis (OA), evaluating of the degree of
inflammation by x-ray is difficult.
Objectives: We used contrast-enhanced US and MRI to detect synovial
process in patients with painful knee OA compared to healthy controls
Methods: 41 patients (mean age 65 years) with knee OA underwent
contrast-enhanced US (12.5 MHz for B mode and 3-8 MHz linear for contrast
enhanced US). 34 patients underwent MRI (0.2T). Six healthy controls (mean age
36 years) underwent US and MRI. The synovial process including effusion and
synovial proliferation was classified as active and inactive by power Doppler
(PD) US and contrast enhancement by US (SonoVue®) and MRI (Magnevist®).
Clinical data were assessed applying a visual analogue scale (VAS) for pain in
rest and under strain.
Results: The six healthy controls showed no pain under rest or strain
and were tested to be grade 0 for all mentioned US findings. In regards of
these parameters there was a highly significant difference between the six
healthy controls and the 41 patients (p< 0.05).
VAS pain data for patients did only moderately correlate with contrast medium
enhancement in US (Spearman correlation coefficient = 0.386, p= 0.018) as well
as with power Doppler in the superior recess (Spearman correlation coefficient
= 0.366, p= 0.020). Likewise, pain data acquired via VAS did not correlate with
other parameters (effusion, synovial proliferation, and contrast enhancement of
the superior recess in US and MRI). Kappa analysis showed a value of 0.632
between US and MRI in regards of the effusion in the superior recess. If MRI
was taken as the gold standard there was a sensitivity of 72% for assessing
effusion in the superior recess and 81% for assessing effusion in the lateral
recess. Otherwise, the detection of effusion in the lateral recess was superior
by US (85%) than MRI (56%). Contrast enhancement between US and MRI showed a
moderate to good correlation (Pearson correlation coefficient= 0.543, p=
0,001).
Conclusion: There is only sparse correlation between pain as assessed by
VAS and disease activity (synovitis) as assessed by US and/or MRI. US and MRI
showed good correlation in measuring effusion and contrast enhancement using
the new contrast medium SonoVue®. Contrast enhanced US has shown to be a good
model for the evaluation of an inflammatory process in the setting of
osteoarthritis, and seems to be an interesting model in testing new
antirheumatic drugs in other inflammatory diseases, e.g. rheumatoid arthritis,
in the future.
Diagnostics and imaging
procedures
Citation: Ann Rheum Dis 2007;66(Suppl II):571