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Pediatric Radiology
Published in: Pediatric Radiology 6/2007

01-06-2007 | Original Article

Quantitative MR characterization of disease activity in the knee in children with juvenile idiopathic arthritis: a longitudinal pilot study

Authors: Dagnachew W. Workie, T. Brent Graham, Tal Laor, Akila Rajagopal, Kendall J. O’Brien, Wendy A. Bommer, Judy M. Racadio, Norah J. Shire, Bernard J. Dardzinski

Published in: Pediatric Radiology | Issue 6/2007

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Abstract

Background

The development of a quantifiable and noninvasive method of monitoring disease activity and response to therapy is vital for arthritis management.

Objective

The purpose of this study was to investigate the utility of quantitative dynamic contrast-enhanced MRI (DCE-MRI) based on pharmacokinetic (PK) modeling to evaluate disease activity in the knee and correlate the results with the clinical assessment in children with juvenile idiopathic arthritis (JIA).

Materials and methods

A group of 17 children with JIA underwent longitudinal clinical and laboratory assessment and DCE-MRI of the knee at enrollment, 3 months, and 12 months. A PK model was employed using MRI signal enhancement data to give three parameters, Ktrans ′ (min−1), kep (min−1), and Vp ′ and to calculate synovial volume.

Results

The PK parameters, synovial volumes, and clinical and laboratory assessments in most children were significantly decreased (P < 0.05) at 12 months when compared to the enrollment values. There was excellent correlation between the PK and synovial volume and the clinical and laboratory assessments. Differences in MR and clinical parameter values in individual subjects illustrate persistent synovitis when in clinical remission.

Conclusion

A decrease in PK parameter values obtained from DCE-MRI in children with JIA likely reflects diminution of disease activity. This technique may be used as an objective follow-up measure of therapeutic efficacy in patients with JIA. MR imaging can detect persistent synovitis in patients considered to be in clinical remission.
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Metadata
Title
Quantitative MR characterization of disease activity in the knee in children with juvenile idiopathic arthritis: a longitudinal pilot study
Authors
Dagnachew W. Workie
T. Brent Graham
Tal Laor
Akila Rajagopal
Kendall J. O’Brien
Wendy A. Bommer
Judy M. Racadio
Norah J. Shire
Bernard J. Dardzinski
Publication date
01-06-2007
Publisher
Springer-Verlag
Published in
Pediatric Radiology / Issue 6/2007
Print ISSN: 0301-0449
Electronic ISSN: 1432-1998
DOI
https://doi.org/10.1007/s00247-007-0449-6

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