scholarly journals CLINICAL CHARACTERISTICS AND TREATMENT PROFILE OF PSORIATIC ARTHRITIS’ PATIENTS IN A TERTIARY HOSPITAL AND ITS RELATIONS WITH SACROILIITIS IN MAGNETIC RESONANCE IMAGING AND CHARACTERIZATION OF SOCIODEMOGRAPHIC PROFILE

2019 ◽  
Author(s):  
ANTONIO HELDER COSTA VASCONCELOS ◽  
SAMILY CORDEIRO DE OLIVEIRA ◽  
MARCIO VALE BRAGA ◽  
JAILSON RODRIGUES LOPES ◽  
CARLOS LEITE DE MACEDO FILHO ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Psoriatic Arthritis ◽  
Magnetic Resonance ◽  
Clinical Characteristics ◽  
Tertiary Hospital ◽  
Resonance Imaging ◽  
Sociodemographic Profile ◽  
Treatment Profile

scholarly journals AB1086 POWER DOPPLER AND SPECTRAL DOPPLER ULTRASOUND IN SUSPECTED ACTIVE SACROILIITIS: A COMPARISON WITH MAGNETIC RESONANCE IMAGING AS GOLD STANDARD

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 1832.1-1832
Author(s):  
P. Falsetti ◽  
E. Conticini ◽  
C. Baldi ◽  
M. Bardelli ◽  
S. Gentileschi ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Diagnostic Accuracy ◽  
Doppler Ultrasound ◽  
Gold Standard ◽  
Clinical Characteristics ◽  
Power Doppler ◽  
Resonance Imaging ◽  
Asas Criteria ◽  
Spectral Doppler

Background:SIJ involvement is a characteristic feature of Spondylarthritis (SpA). Magnetic Resonance imaging (MRI) has been included in the new Assessment of SpA International Society (ASAS) criteria for the classification of Axial SpA. Gray scale US, Color Doppler ultrasound (CDUS), contrast-enhanced CDUS, and spectral Doppler (SD) US has been used in few works to evaluate the inflammatory activity of the SIJ with not conclusive results. Power Doppler ultrasound (PDUS) was not yet applied to the study of SIJ with active SI.Objectives:The aim of this work was to study with PDUS and SD US the SIJ of patients with suspected active SI, to describe inflammatory flows with spectral wave analysis (SWA) in duplex Doppler US, and to correlate US data with clinical characteristics and the presence of bone marrow edema (BME) in MRI.Methods:22 patients (18 females and 4 males, mean age 35 years) with new onset of inflammatory back pain (IBP), were included. Every patient underwent an US examination in prone position. The sonographers were blinded to the clinical data of the patient. A Esaote Twice US machine, equipped with a convex multifrequency 1-8 MHz probe, was used, with standardized parameters: 1-5 MHz for gray scale, 1.9-2.3 MHz frequency for Doppler with Pulse Repetition Frequency (PRF) of 1.0 KHz and a color gain just under the artifact limit. SIJ was located as the hypoechoic triangle delimited between the sacrum and iliac bone, and the posterior SI ligament as the upper margin. The first sacral foramen was always localized to avoid measurement of the normal pre-sacral arteries. The PDUS was applied, and if any signals were detected in the SIJ, they were scored with a 3-points scale: 0= absence of signals, 1= isolate vessels, 2= more than one vessel. The signals were also classified as intra-articular or peri-articular. The same vessels were also evaluated using quantitative SD calculating the Resistive Index (RI=peak of systolic flow- end diastolic flow/peak systolic flow), ranging between 0 and 1. Every patient underwent MRI of SIJ within the same week, before treatment. A statistical analysis was performed, estimating the sensitivity and specificity against the gold standard (presence of BME in the same SIJ according to ASAS criteria). The Spearman rank not-parametric test was applied to correlate the presence and grading of BME with PDUS grading and RI. A regression analysis was applied between PDUS results and clinical characteristics.Results:In 14/22 SIJ MRI revealed BME. In 13 of them, PDUS confirmed abnormal hypervascularisation in the intrarticular portion of SI, and in 3 in the periarticular site too. Two SIJ showed hypervascularisation at PD with no BME in MRI. A significant correlation was demonstrated between positivity and grading of PD and presence of BME in MRI (p=0.0005). SD analysis demonstrated low Resistance Index (RI) values in 14 SIJ (mean 0.57). An inverse correlation was demonstrated between RI and grading of BME in MRI (r= -0,6229, p= 0,044). The diagnostic accuracy of SD for detection of active SI varied on the basis of RI cut-off value. The best values of sensitivity (62,5%) and specificity (61,5%) were obtained with a RI cut-off values of 0.60. A multiple regression model demonstrated a significant relationship between PDUS signals and ASDAS (p=0.0382), but not with inflammatory reactants.Conclusion:PDUS and SD US of SIJ can be useful as first imaging assessment in suspected active SI, demonstrating a good diagnostic accuracy compared with MRI. Intra-articular low RI values (<0.60) on SD indicate active SI with good accuracy. Moreover, PDUS signals into the SIJ correlate with clinical symptoms but not with inflammation reactants.Figure 1.Doppler US in SI.Right SIJ with a Doppler signal along the posterior SIJ ligament, and another Doppler signal into the joint, where SD analysis gave a RI of 0,62.Disclosure of Interests:None declared

scholarly journals POS1349 THE JOINT INVOLVEMENT IN ADULT ONSET STILL’S DISEASE IS CHARACTERISED BY A PECULIAR MAGNETIC RESONANCE IMAGING AND A SPECIFIC TRANSCRIPTOMIC PROFILE

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 957.1-957
Author(s):  
P. Ruscitti ◽  
A. Barile ◽  
O. Berardicurti ◽  
S. Iafrate ◽  
P. DI Benedetto ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Signal Intensity ◽  
Clinical Characteristics ◽  
Joint Involvement ◽  
Resonance Imaging ◽  
Bone Erosions ◽  
Transcriptomic Profile ◽  
Synovial Tissues ◽  
Bone Oedema

Background:Adult onset Still’s disease (AOSD) is a rare systemic autoinflammatory disease and joint involvement is one of its clinical manifestations [1]. Arthritis, either oligoarthritis or bilateral symmetrical rheumatoid arthritis-like polyarthritis, is another common clinical feature of AOSD, with a migrating pattern at the beginning and becoming stable over the time [1].Objectives:The aims of the study were to assess joint involvement in AOSD by using magnetic resonance imaging (MRI), to describe main patterns of involvement, and associated clinical characteristics, and to evaluate the global transcriptomic profile of synovial tissues in AOSD to elucidate possible pathogenic pathways involved with.Methods:AOSD patients, who underwent to magnetic resonance imaging (MRI) exam on joints, were assessed to describe patterns of joint involvement and associated clinical characteristics. Some synovial tissues were collected for RNA-sequencing purposes.Results:In this study, 31 patients with AOSD (mean age 42.3 ± 15.2 years, 54.8% male gender), who underwent to at least one MRI exam on joints, were assessed. The most common MRI finding was the presence of synovitis on 60.5%, mainly in peripheral affected joints. MRI revealed a mild to moderate proliferative synovitis, as thickening of the synovial membrane, with low to intermediate signal intensity on T1-weighted images and intermediate to high signal intensity on T2-fat saturated weighted and STIR images, suggesting the presence of a hyperplastic than of a hypertrophied synovial tissue. Bone oedema and bone erosions were reported on 34.9% and 25.6% MRI exams, respectively. In all patients but one, bone erosions were synchronous with bone oedema, overlapping completely the locations. Assessing clinical characteristics in patients with MRI-erosions, a higher prevalence of splenomegaly, a more frequent chronic disease course, lower levels of erythrocyte sedimentation rate and ferritin was observed.Assessing the synovial tissues of some AOSD patients, a moderate perivascular mononuclear infiltrate in the sub-lining stroma of hip synovial tissues was observed, whereas the lining cells were relatively unremarkable. In addition, interleukin (IL)-1β, IL-6, TNF, and heavy ferritin subunit (FeH) were found on AOSD synovial tissues.An RNA-sequencing analysis assessed the global transcriptomic profile of synovial tissues on AOSD patients and matched-controls. Assessing IL-1 pathway, we found an increased expression of il1a, il1b, il1rap, il1r1, il18r1, and Il18bp on AOSD tissues when compared with controls. In IL-6 pathway, we found an increased expression of il6 and il6st/gp130 on AOSD synovial tissues whereas an increased expression of il6r was shown on the controls. Among genes involved in TNF pathway, tnf, traf1, traf2, tnfaip3 and tnfrsf1a resulted to be more expressed in AOSD synovial tissues than in controls. Finally, fth1 and ftl were more expressed in AOSD patients than controls, when we explored the iron uptake and transport pathway.Conclusion:A peculiar MRI pattern of joint involvement in AOSD was reported; the most common finding was the presence of synovitis, characterised by intermediate to high signal intensity on T2-fat-saturated weighted and STIR images. Bone erosions and bone oedema were also observed. This MRI pattern was associated with a hyper-activation of IL-1, IL-6, and TNF pathways together with a hyper-expression of ferritin genes on AOSD synovial tissues.References:[1]Giacomelli R, Ruscitti P, Shoenfeld Y. A comprehensive review on adult onset Still’s disease. J Autoimmun. 2018;93:24-36.Disclosure of Interests:None declared

scholarly journals Visualization and Temporal/Spatial Characterization of Cardiac Radiofrequency Ablation Lesions Using Magnetic Resonance Imaging

Circulation ◽  
2000 ◽  
Vol 102 (6) ◽  
pp. 698-705 ◽  
Author(s):  
Albert C. Lardo ◽  
Elliot R. McVeigh ◽  
Pitayadet Jumrussirikul ◽  
Ronald D. Berger ◽  
Hugh Calkins ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Radiofrequency Ablation ◽  
Magnetic Resonance ◽  
Resonance Imaging ◽  
Spatial Characterization
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