Preliminary Application Study Of DWI-ADC And DKI In The Evaluation Of Synovial Membrane In Rheumatoid Arthritis

Part?Preliminary application of diffusion-weighted imaging ADC values in the evaluation of synovitisObjective:To explore the preliminary application of the apparent diffusion coefficient(ADC)values of magnetic resonance diffusion weighted imaging(DWI)in the evaluation of synovitis.Methods:A total of 29 patients confirmed or suspected rheumatoid arthritis(RA)were enrolled in the prospective study.All patients underwent wrist joint 3.0T magnetic resonance(MR)examination,including DWI and enhanced MR sequence,to analyze the mean ADC values and minimum ADC values of suspected synovitis or effusion.According to the degree of enhancement,the lesions were divided into score 0,score1,score 2,and score 3,representing joint effusion,mild synovitis,moderate synovitis and severe synovitis,respectively.The Spearman correlation test was used to evaluate the correlation.The receiver operating characteristic curve(ROC)curve analysis was used to analyze the diagnostic performance of the mean ADC value and the minimum ADC value.Results:The ADC values(including the mean and minimum ADC values)of score 0were higher than that of score(1?3),and the difference were statistically significant(P<0.001).There was a significant negative correlation between the mean and minimum ADC values and the enhancement degree of synovitis(r=-0.740,-0.549,respectively,P<0.001).When the mean ADC threshold was 1.655×10^-3 mm²/s,ROC curve analysis showed that the sensitivity,specificity and AUC of the mean ADC values were 84.9%,92.5%and 0.939,for differentiating score(1?3)group from score 0group.Conclusion:The ADC values can be used for the evaluation of synovitis,and have potential application value in diagnosis and treatment evaluation of RA.Part ? Preliminary application of diffusion kurtosis imaging in the evaluation of synovitisObjective: To explore the feasibility of diffusion kurtosis imaging(DKI)in the noninvasive evaluation of wrist synovitis.Methods: A total of 40 patients confirmed or suspected rheumatoid arthritis(RA)were enrolled in the prospective study.3.0T MR imaging including the DKI sequence(b = 0,500,1000,1500,2000 s/mm2)was performed.A total of 210 regions of interest(ROIs)were confirmed and DKI parameters were generated.According to the modified RAMRIS system,the lesions are divided into 0 points(effusion)and 1-3 points(mild,moderate,and severe synovitis).The receiver operating characteristic curve analysis was used to analyze the diagnostic efficacy of DKI parameters for different synovitis scores.Results: There were significant differences in ADC,D,and K values among different synovitis scores(all P < 0.001).Synovitis scores were negatively correlated with the ADC and D values significantly(r =-0.725,-0.757,respectively,P < 0.001),but positively correlated with the K values significantly(r = 0.429,P < 0.001).The area under the curve values of D,ADC,and K values were 0.884,0.874,and 0.728 for differentiating score(1 3)from score 0,respectively.D and ADC had similar diagnostic performance,and both were higher than K in evaluating synovitis.Conclusion: DKI may be promising as a noninvasive method for evaluating synovitis in the hands of RA patients,and the D and ADC values showed similar diagnostic performance,both of which were higher than K values.