Document Detail


Power Doppler sonography and pulse-inversion harmonic imaging in evaluation of rheumatoid arthritis synovitis.
MedLine Citation:
PMID:  17242261     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: This study evaluates the value of contrast-enhanced pulse-inversion harmonic imaging (PIHI) to detect synovial vascularization and thus the therapeutic effects of prednisolone treatment on the inflammation in finger joints in rheumatoid arthritis (RA). MATERIALS AND METHODS: Before and after 7 days of mid- to high-dose steroid therapy, blood tests and clinical and sonographic examinations were assessed in 14 patients. Two hundred eighty finger joints (metacarpophalangeal [MCP] I-V, interphalangeal [IP], and proximal interphalangeal [PIP] II-V) were investigated on power Doppler sonography to determine, in each patient, the finger joint with the strongest hypervascularization and to score the synovial vascularization. Further dynamic examination of the selected joint was performed on PIHI after i.v. administration of a second-generation sonographic contrast medium. Vascularization was quantified by calculating the area under the time-intensity curves. The changes in signal intensities before and after therapy were correlated with clinical examinations (disease activity score [DAS]). RESULTS: The score of the joint with the strongest hypervascularization assessed by power Doppler sonography decreased significantly from 1.7 to 1.3 (p < 0.01); however, in six patients, no change was assessed after steroid therapy. In all patients, a significant reduction in PIHI signals was observed after therapy (p < 0.05). The baseline and follow-up median values of the area under the time-intensity curves were 8.56 +/- 1.28 and 7.65 +/- 0.66, respectively. The median values of the DAS decreased significantly from 4.90 +/- 0.86 to 3.6 +/- 1.0 (p < 0.01) 7 days after the steroid therapy. CONCLUSION: PIHI and power Doppler sonography enable the detection of synovial perfusion alterations after steroid therapy and, therefore, may be useful tools for the evaluation of active inflammation in RA and for the assessment of therapeutic response. However, minor changes of synovial vascularization can be better detected on PIHI than on power Doppler sonography.
Authors:
Claudia Schueller-Weidekamm; Christian Krestan; Gerd Schueller; Theresa Kapral; Daniel Aletaha; Franz Kainberger
Publication Detail:
Type:  Clinical Trial; Journal Article    
Journal Detail:
Title:  AJR. American journal of roentgenology     Volume:  188     ISSN:  1546-3141     ISO Abbreviation:  AJR Am J Roentgenol     Publication Date:  2007 Feb 
Date Detail:
Created Date:  2007-01-23     Completed Date:  2007-02-20     Revised Date:  2008-02-15    
Medline Journal Info:
Nlm Unique ID:  7708173     Medline TA:  AJR Am J Roentgenol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  504-8     Citation Subset:  AIM; IM    
Affiliation:
Department of Diagnostic Radiology, Medical University of Vienna, Waehringer Guertel 18-20, A-1090 Vienna, Austria. claudia.schueller-weidekamm@meduniwien.ac.at
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MeSH Terms
Descriptor/Qualifier:
Adult
Anti-Inflammatory Agents / administration & dosage
Arthritis, Rheumatoid / drug therapy*,  ultrasonography*
Contrast Media
Female
Finger Joint / drug effects,  ultrasonography*
Humans
Image Enhancement / methods
Image Interpretation, Computer-Assisted / methods
Male
Middle Aged
Prednisolone / administration & dosage*
Prognosis
Reproducibility of Results
Sensitivity and Specificity
Synovitis / drug therapy*,  ultrasonography*
Treatment Outcome
Ultrasonography / methods*
Chemical
Reg. No./Substance:
0/Anti-Inflammatory Agents; 0/Contrast Media; 50-24-8/Prednisolone

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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