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Pediatric Radiology

, Volume 49, Issue 5, pp 638–645 | Cite as

Prolonged time between intravenous contrast administration and image acquisition results in increased synovial thickness at magnetic resonance imaging in patients with juvenile idiopathic arthritis

  • Anouk M. BarendregtEmail author
  • E. Charlotte van Gulik
  • Paul F. C. Groot
  • Koert M. Dolman
  • J. Merlijn van den Berg
  • Amara Nassar-Sheikh Rashid
  • Dieneke Schonenberg-Meinema
  • Cristina Lavini
  • Karen Rosendahl
  • Robert Hemke
  • Taco W. Kuijpers
  • Mario Maas
  • Charlotte M. Nusman
Original Article

Abstract

Background

Post-contrast synovial thickness measurement is necessary for scoring disease activity in juvenile idiopathic arthritis (JIA). However, the timing of post-contrast sequences varies widely among institutions. This variation in timing could influence thickness measurements.

Objective

To measure thickness of the synovial membrane on early and late post-contrast knee magnetic resonance (MR) images of patients with JIA.

Materials and methods

Dynamic contrast-enhanced T1-weighted knee MR images of 53 children with JIA with current or past knee arthritis were used to study synovial thickness at time point 1 (about 1 min) and time point 2 (about 5 min after contrast administration). Two experienced readers, who were blinded for the time point, independently measured synovial thickness at a predefined, marked location in the patellofemoral compartment on randomized images. Synovial thickness at the two time points was compared using the Wilcoxon signed rank test. Repeatibility of the synovial thickness measurements was studied using intraclass correlation coefficients and Bland-Altman plots.

Results

Median synovial thickness of the 53 patients (median age: 13.5 years, 59% female) increased with prolonged post-contrast interval with a synovial thickness of 1.4 mm at time point 1 and a synovial thickness of 1.5 mm at time point 2 (P<0.001). Repeated synovial thickness measurements showed an intraclass correlation coefficient (ICC) of 0.75, P<0.05 for time point 1 and an ICC of 0.91, P<0.05 for time point 2.

Conclusion

Post-contrast synovial membrane thickness measurements are time-dependent. Therefore, standardization of post-contrast image acquisition timing is important to achieve consistent grading of synovial inflammation.

Keywords

Adolescents Children Contrast media Juvenile arthritis Knee joint Magnetic resonance imaging Synovial membrane 

Notes

Acknowledgements

This study received funding by the Academic Medical Center through an MD/PhD scholarship awarded to Anouk M. Barendregt.

Compliance with ethical standards

Conflicts of interest

None

Supplementary material

247_2018_4332_MOESM1_ESM.png (380 kb)
Online Resource 1 Bland-Altman plots of the intra-reader repeatability (PNG 380 kb)

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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  • Anouk M. Barendregt
    • 1
    • 2
    Email author
  • E. Charlotte van Gulik
    • 1
    • 2
  • Paul F. C. Groot
    • 1
  • Koert M. Dolman
    • 3
    • 4
    • 5
  • J. Merlijn van den Berg
    • 2
  • Amara Nassar-Sheikh Rashid
    • 2
  • Dieneke Schonenberg-Meinema
    • 2
  • Cristina Lavini
    • 1
  • Karen Rosendahl
    • 6
    • 7
  • Robert Hemke
    • 1
  • Taco W. Kuijpers
    • 2
  • Mario Maas
    • 1
  • Charlotte M. Nusman
    • 1
    • 2
  1. 1.Department of Radiology and Nuclear Medicine, Amsterdam UMCUniversity of AmsterdamAmsterdamThe Netherlands
  2. 2.Department of Pediatric Hematology, Immunology, Rheumatology and Infectious Disease, Emma Children’s Hospital, Amsterdam UMCUniversity of AmsterdamAmsterdamThe Netherlands
  3. 3.Department of Pediatric Rheumatology, ReadeAmsterdamthe Netherlands
  4. 4.Department of Pediatric RheumatologyAmsterdamthe Netherlands
  5. 5.Department of Pediatric RheumatologyAmsterdamthe Netherlands
  6. 6.Section of Pediatric RadiologyHaukeland University HospitalBergenNorway
  7. 7.Department of Clinical Medicine, K1University of BergenBergenNorway

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