@article {Teruel1766, author = {Jose R. Teruel and Andrew J. Burghardt and Julien Rivoire and Waraporn Srikhum and Susan M. Noworolski and Thomas M. Link and John B. Imboden and Xiaojuan Li}, title = {Bone Structure and Perfusion Quantification of Bone Marrow Edema Pattern in the Wrist of Patients with Rheumatoid Arthritis: A Multimodality Study}, volume = {41}, number = {9}, pages = {1766--1773}, year = {2014}, doi = {10.3899/jrheum.131564}, publisher = {The Journal of Rheumatology}, abstract = {Objective. To quantify bone structure and perfusion parameters in regions of bone marrow edema pattern (BMEP), non-edematous bone marrow (NBM), and pannus tissue areas in the wrists of patients with rheumatoid arthritis (RA) using 3-Tesla (3T) magnetic resonance imaging (MRI), and high resolution peripheral quantitative computed tomography (HR-pQCT). Methods. Sixteen subjects fulfilling American College of Rheumatology classification were imaged using a HR-pQCT system and a 3T MRI scanner with an 8-channel wrist coil. Coronal T2-weighted and dynamic contrast-enhanced (DCE-MRI) images were acquired. BMEP and pannus tissue areas were segmented semiautomatically in T2-weighted images. NBM areas were placed at a similar distance from the joint space as BMEP regions. MR and HR-pQCT images were registered, and bone variables were calculated within the BMEP and NBM regions. Perfusion parameters in BMEP, pannus tissue, and NBM regions were calculated based on the signal-time curve obtained from DCE-MRI. Results. Eighteen BMEP areas were segmented, 15 of them presented proximal to pannus-filled erosions. Significant increases in bone density and trabecular thickness and number were observed in all BMEP regions compared to NMB (p \< 0.05). Significantly elevated perfusion measures were observed in both BMEP and pannus tissue regions compared to NBM (p \< 0.05). Conclusion. BMEP regions showed significantly increased bone density and structures as well as perfusion measures, suggesting bone remodeling and active inflammation. Combining MRI and HR-pQCT provides a powerful multimodality approach for understanding BMEP and erosions, and for potentially identifying novel imaging markers for disease progression in RA.}, issn = {0315-162X}, URL = {https://www.jrheum.org/content/41/9/1766}, eprint = {https://www.jrheum.org/content/41/9/1766.full.pdf}, journal = {The Journal of Rheumatology} }