Technische Innovationen in der Magnetresonanztomographie (MRT) haben die bildgebende Diagnostik in der Rheumatologie maßgeblich verbessert. Während sich bei der rheumatoiden Arthritis die MRT zunehmend als diagnostisches Instrument etabliert, wird sie bei den selteneren Erkrankungen, wie den Konnektivitiden (Systemsklerose, Lupus) oder den Myositiden (Polymyositis, Dermatomyositis), bisher nur in Einzelfällen eingesetzt. Die MRT kann jedoch gerade dann wertvolle Informationen über das Ausmaß der Erkrankung, ihre Folgeerscheinungen und Komplikationen liefern, wenn Röntgenaufnahmen oder ultrasonographische Untersuchungen unauffällig waren. Die sinnvolle Verankerung der MRT in Diagnosealgorithmen und Therapiemonitoring der Kollagenosen ist zukünftig einer der Schwerpunkte in der Zusammenarbeit von Rheumatologen, Dermatologen und Radiologen.
Literatur
1
Sugimoto H, Takeda A, Masuyama J, Furuse M.
Early-stage rheumatoid arthritis: diagnostic accuracy of MR imaging.
Radiology.
1996;
198
85-192
2
Been M, Thomson B J, Smith M A, Ridgway J P, Douglas R H, Been M, Best J J, Muir A L.
Myocardial involvement in systemic lupus erythematosus detected by magnetic resonance imaging.
Eur Heart J.
1988;
9
250-1256
3
Boumpas D T, Patronas N J, Dalakas M C, Hakim C A, Klippel J H, Balow J E.
Acute transverse myelitis in systemic lupus erythematosus: magnetic resonance imaging and review of the literature.
J Rheumatol.
1990;
17
9-92
9
Jimenez-Moreno J, Selva-O’Callaghan A, Rovira-Canellas A, Solans-Laque R, Len O, Olias M, Fonollosa-Pla V, Vilardell-Tarres M.
Trigeminal sensory neuropathy in systemic sclerosis.
Br J Rheumatol..
1998;
37
587-589
14
Bonel H M, Schneider P, Seemann M D, Huegli R, Srivastav S, Lodemann K P, Reiser M.
MR imaging of the wrist in rheumatoid arthritis using gadobenate dimeglumine.
Skeletal Radiol.
2001;
30
15-24
15
Savnik A, Malmskov H, Thomsen H S, Bretlau T, Graff L B, Nielsen H, Danneskiold-Samsoe B, Boesen J, Bliddal H.
MRI of the arthritic small joints: comparison of extremity MRI (0.2 T) vs. high-field MRI (1.5 T).
Eur Radiol.
2001;
11
1030-1038
16
Horiki T, Moriuchi J, Takaya M, Uchiyama M, Hoshina Y, Inada K, Inoko H, Tsuji K, Ichikawa Y.
The coexistence of systemic sclerosis and rheumatoid arthritis in five patients. Clinical and immunogenetic features suggest a distinct entity.
Arthritis Rheum.
1996;
39
152-156
17
Wulffraat N M, Woo P, Rooney M, de Meer K, Kuis W.
Atypical juvenile generalized scleroderma presenting as polyarthritis and failure to thrive.
Br J Rheumatol.
1998;
37
222-227
20
Halland A M, Klemp P, Botes D, van Heerden B B, Loxton A, Scher A T.
Avascular necrosis of the hip in systemic lupus erythematosus: the role of magnetic resonance imaging.
Br J Rheumatol.
1993;
32
972-976
21
Bluemke D A, Petri M, Zerhouni E A.
Femoral head perfusion and composition: MR imaging and spectroscopic evaluation of patients with systemic lupus erythematosus and at risk for avascular necrosis.
Radiology.
1995;
197
433-438
22
Guillaume M P, Brandelet B, Peretz A.
Unusual high frequency of multifocal lesions of osteonecrosis in a young patient with systemic lupus erythematosus.
Br J Rheumatol..
1998;
37
1248-1249
23
Houssiau F A, N’Zeusseu T A, Depresseux G, Maldague B E, Malghem J, Devogelaer J P, Vande B erg.
Magnetic resonance imaging-detected avascular osteonecrosis in systemic lupus erythematosus: lack of correlation with antiphospholipid antibodies.
Br J Rheumatol.
1998;
37
448-453
24
Aranow C, Zelicof S, Leslie D, Solomon S, Barland P, Norman A, Klein R, Weinstein A.
Clinically occult avascular necrosis of the hip in systemic lupus erythematosus.
J Rheumatol.
1997;
24
2318-2322
27
Reimers C D, Schedel H, Fleckenstein J L.
Magnetic resonance imaging of skeletal muscles in idiopathic inflammatory myopathies of adults.
J Neurol.
1994;
241(5)
306-314
29 Beese M, Winkler G. Autoimmunerkrankungen mit neuromuskulärer Beteiligung. In: Martin Beese, Gerhard Winkler (Hrsg) MRT der Muskulatur. 1997: 333-357
31
Stonecipher M R, Jorizzo J L, Monu J, Walker F, Sutej P G.
Dermatomyositis with normal muscle enzyme concentrations. A single-blind study of the diagnostic value of magnetic resonance imaging and ultrasound.
Arch Dermatol.
1994;
130
1294-1299
33
Bartlett M L, Ginn L, Beitz L, Villalba M L, Plotz P, Bacharach S L.
Quantitative assessment of myositis in thigh muscles using magnetic resonance imaging.
Magn Reson Imaging.
1999;
17
183-191
35
Park J H, Vansant J P, Kumar N G, Gibbs S J, Curvin M S, Price R R, Partain C L, James A E Jr..
Dermatomyositis: correlative MR imaging and P-31 MR spectroscopy for quantitative characterization of inflammatory disease.
Radiology.
1990;
177
473-479
36
Park J H, Olsen N J, King L E Jr., Vital T, Buse R, Kari S, Hernanz-Schulman M, Price R R.
Use of magnetic resonance imaging and P-31 magnetic resonance spectroscopy to detect and quantify muscle dysfunction in the amyopathic and myopathic variants of dermatomyositis.
Arthritis Rheum.
1995;
38
68-77
37
Adams L B, Park J H, Olsen N J, Gardner E S, Hernanz-Schulman M, King L E Jr.
Quantitative evaluation of improvement in muscle weakness in a patient receiving extracorporeal photopheresis for scleroderma: magnetic resonance imaging and magnetic resonance spectroscopy.
J Am Acad Dermatol.
1995;
33
519-522
38
Park J H, Vital T L, Ryder N M, Hernanz-Schulman M, Partain C L, Price R R, Olsen N J.
Magnetic resonance imaging and P-31 magnetic resonance spectroscopy provide unique quantitative data useful in the longitudinal management of patients with dermatomyositis.
Arthritis Rheum.
1994;
37
736-746
41
Richard S, Querleux B, Bittoun J, Joilvet O, Idy-Peretti I, de Lacharriere O, Leveque J L.
Characterization of the Skin in Vivo by High Resolution Magnetic Resonance Imaging: Water Behavior and Age-Related Effects.
Invest Dermatol.
1993;
100
705-709
42
Bonel H, Messer G, Seemann M, Walchner M, Rocken M, Reiser M.
MRT der Finger bei systemischer Sklerodermie. Erste Ergebnisse mit kontrastverstärkten Untersuchungen an einem dedizierten MRT-System.
Radiologe.
1997;
37
794-801
