Imaging of arthritis of the phalangeal joints using high-resolved MRI techniques – a feasibility study

Purpose: To evaluate the feasibility of high-resolution MR imaging of the phalangeal joints at 3 Tesla in patients with arthritis.

Methods: In 8 patients with arthritis of the hand, high-resolution MR imaging was performed with a 3 Tesla MR scanner (TRIO, Siemens), using a dedicated transmit-receive wrist-coil. Results were compared with clinical findings and ultrasound examinations. The imaging protocol included coronal TSE T2w (TR/TE=4000/106 ms, 2 averages, 120mm FOV, 384 matrix, fat suppressed) and T1w MRI (TR/TE=841/12 ms, 1 average, 120mm FOV, 384 matrix, 1.5mm slice thickness). Additionally, a multiphase angiography (T1w 3D FLASH; TR/TE=4.3/1.29 ms, 20mm FOV, flip angle=20 degree, resulting voxel size=1mm³ [isotropic], time resolution=12s) was conducted, followed by coronal T1w MRI with fat suppression. Total examination time was approximate 30min.

Results: Synovial swelling and bone destruction were clearly visualized and corresponded to the clinical findings. Infested joints demonstrated intra-individual variations in degree and speed of contrast enhancement. Additionally, local variations in blood supply and vessel thickness occurred. However, due to the small field of view and coil design, only parts of the hand could be examined.

Conclusion: High-resolution MR-imaging of arthritic joints of the hand provides detailed information about bone and cartilage destruction as well as synovial swelling. This information may be used for early diagnosis and for therapy follow-up of arthritis.