Pediatric radiology · 2026
5.0-T magnetic resonance imaging and contrast-enhanced magnetic resonance angiography for the evaluation of juvenile idiopathic arthritis.
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Yao Qiong, Cai Guanke, Yang Lei, Shen Jin, Liu Haimei, Sun Li, Lu Kai, Guo Xin, Li Hao, Hu Xihong
Аннотация
BACKGROUND: Magnetic resonance imaging (MRI) is the most sensitive non-invasive method for assessing joint lesions in juvenile idiopathic arthritis (JIA), but conventional protocols cannot simultaneously depict synovial inflammation and the associated vascular changes.
OBJECTIVE: To assess changes in the "synovium-vascular axis" of the hand in children with JIA using 5.0-T MRI and contrast-enhanced magnetic resonance angiography (CE-MRA).
MATERIALS AND METHODS: Twenty children with JIA and 10 age- and sex-matched healthy controls underwent hand 5.0-T MRI, including contrast-enhanced T1-weighted imaging and CE-MRA. The maximum synovial thickness, enhancement rate, bone marrow edema score, palmar digital artery diameter ratios, palmar arch integrity, distal microcirculation score, and vascular tortuosity were quantified. Correlations with the Juvenile Arthritis Disease Activity Score-27 (JADAS-27), erythrocyte sedimentation rate (ESR), and C-reactive protein (CRP) were analyzed.
RESULTS: Compared with controls, the JIA group showed higher maximum synovial thickness (5.19±2.35 mm vs. 0.83±0.24 mm, P<0.001), enhancement rate (0.44±0.20 vs. 0.20±0.14, P=0.002), bone marrow edema score (median 7.50 vs. 0, P<0.001), and vascular tortuosity (2.0 vs. 0, P<0.001), but lower common palmar digital artery diameter ratio (0.690 vs. 1.000, P<0.001) and microcirculation score (1.0 vs. 3.0, P<0.001). The bone marrow edema score (r=0.674, P=0.001), maximum synovial thickness (r=0.581, P=0.007), and enhancement rate (r=0.634, P=0.003) correlated positively with JADAS-27, and the bone marrow edema score was independently associated with ln(JADAS-27) (standardized β=0.677, P=0.005).
CONCLUSION: Combined 5.0-T MRI and CE-MRA revealed a distinct pattern of synovial inflammation, arterial narrowing, and impaired distal microcirculatory perfusion in children with JIA. CE-MRA-derived vascular parameters are candidate exploratory imaging markers requiring validation in larger multicenter cohorts.
OBJECTIVE: To assess changes in the "synovium-vascular axis" of the hand in children with JIA using 5.0-T MRI and contrast-enhanced magnetic resonance angiography (CE-MRA).
MATERIALS AND METHODS: Twenty children with JIA and 10 age- and sex-matched healthy controls underwent hand 5.0-T MRI, including contrast-enhanced T1-weighted imaging and CE-MRA. The maximum synovial thickness, enhancement rate, bone marrow edema score, palmar digital artery diameter ratios, palmar arch integrity, distal microcirculation score, and vascular tortuosity were quantified. Correlations with the Juvenile Arthritis Disease Activity Score-27 (JADAS-27), erythrocyte sedimentation rate (ESR), and C-reactive protein (CRP) were analyzed.
RESULTS: Compared with controls, the JIA group showed higher maximum synovial thickness (5.19±2.35 mm vs. 0.83±0.24 mm, P<0.001), enhancement rate (0.44±0.20 vs. 0.20±0.14, P=0.002), bone marrow edema score (median 7.50 vs. 0, P<0.001), and vascular tortuosity (2.0 vs. 0, P<0.001), but lower common palmar digital artery diameter ratio (0.690 vs. 1.000, P<0.001) and microcirculation score (1.0 vs. 3.0, P<0.001). The bone marrow edema score (r=0.674, P=0.001), maximum synovial thickness (r=0.581, P=0.007), and enhancement rate (r=0.634, P=0.003) correlated positively with JADAS-27, and the bone marrow edema score was independently associated with ln(JADAS-27) (standardized β=0.677, P=0.005).
CONCLUSION: Combined 5.0-T MRI and CE-MRA revealed a distinct pattern of synovial inflammation, arterial narrowing, and impaired distal microcirculatory perfusion in children with JIA. CE-MRA-derived vascular parameters are candidate exploratory imaging markers requiring validation in larger multicenter cohorts.