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Aktuelle Rheumatologie 2017; 42(05): 399-403
DOI: 10.1055/s-0042-106080
Originalarbeit
Georg Thieme Verlag KG Stuttgart · New York

Magnetresonanztomografie peripherer Gelenke – up-date 2016

Magnetic Resonance Imaging of Peripheral Joints: Update 2016
P. Sewerin
1   Poliklinik, Funktionsbereich & Hiller-Forschungszentrum für Rheumatologie, Heinrich-Heine-Universität Düsseldorf, Düsseldorf
,
C. Schleich
2   Institut für diagnostische und interventionelle Radiologie, Heinrich-Heine-Universität Düsseldorf, Düsseldorf
,
B. Ostendorf
1   Poliklinik, Funktionsbereich & Hiller-Forschungszentrum für Rheumatologie, Heinrich-Heine-Universität Düsseldorf, Düsseldorf
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Publication History

Publication Date:
11 August 2016 (online)

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Zusammenfassung

Moderne und innovative bildgebende Verfahren spielen heute in der Rheumatologie eine zunehmend wichtige Rolle und werden dabei regelhaft bei Diagnosestellung und Therapiekontrolle eingesetzt. Neben der Sonografie, welche heute die rechte Hand des Rheumatologen darstellt, ist die Magnetresonanz-Tomografie (MRT), auch und gerade peripherer Gelenke, zunehmend in den wissenschaftlichen Fokus gerückt. Sie ist in der Lage hochsensitiv entzündliche artikuläre, periartikuläre und ossäre Veränderungen (wie die Synovialitis oder das Knochenmarködem) zu erkennen und dann darüber hinaus deutlich früher als bspw. das konventionelle Röntgen erosive Gelenkveränderungen ab zu bilden. Neben diesen Vorteilen ist es heute durch standardisierte Scoring-Systeme möglich MRT-Untersuchungen besser zu vergleichen, wobei hierfür erste vereinfachte Scores entwickelt und evaluiert wurden. Durch neue und innovative Sequenzen können frühzeitig Veränderungen des Knorpels erkannt werden. Dynamische MRT-Sequenzen versprechen eine noch genauere Darstellung lokaler Inflammation und sind neben hybriden bildgebenden Verfahren (z. B. PET-MRT oder SPECT-MRT) aktuell Gegenstand intensiver wissenschaftlicher Forschung.

Abstract

Modern and innovative imaging techniques play an important role in the field of rheumatic diseases today and are used for diagnosis and treatment control on a regular basis. In addition to sonography, which is the “right-hand man” of a rheumatologist today, magnetic resonance imaging (MRI), especially of the peripheral joints, has moved into the focus of scientific research. Modern MRI techniques demonstrate inflammatory articular, periarticular and bony lesions (such as synovitis and bone marrow oedema) with a high level of sensitivity. Moreover they can depict erosive joint damage much earlier than conventional x-rays. In addition to these advantages, standardised scoring systems help to make MRI scans more comparable today, with some initial simplified scores having been developed and evaluated for this purpose. Due to new and innovative MRI sequences, cartilage damage can be detected at an early point in time. Dynamic MRI sequences promise an ever more precise depiction of local inflammation and, along with hybrid imaging techniques (such as PET-MRI or SPECT-MRI), they are currently the focus of intensive scientific research.

Schlüsselwörter

Bildgebung - MRT - Rheumatoide Arthritis - Psoriasis Arthritis

Key words

imaging - MRI - rheumatoid arthritis - psoriasis arthritis
 

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