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DOI: 10.1055/s-0029-1245374
© Georg Thieme Verlag KG Stuttgart · New York
Ultrasound and MRI Measurements of Joint Cartilage in Healthy Children: a Validation Study
Ultraschall- und MRT-Untersuchungen des Gelenkknorpels bei gesunden Kindern: eine ValidierungsstudiePublication History
received: 29.1.2010
accepted: 2.3.2010
Publication Date:
01 June 2010 (online)

Zusammenfassung
Ziel: Bei der juvenilen idiopathischen Arthritis (JIA) sind proliferative Veränderungen der Synovia und Akkumulation von Synovialflüssigkeit als pathologische Veränderungen ursächlich für Schäden am Knorpelgewebe und dem periartikulären Knochen; diese Veränderungen stellen sich im konventionellen Röntgen erst spät dar. Die frühe Detektion von Gelenksveränderungen würden dem Kliniker die zeitige Einleitung adäquater Therapien ermöglichen, die für das Langzeit-Outcome bei JIA essenziell sind. Der Ultraschall (US) spielt bei dieser Fragestellung eine große Rolle, es fehlen aber bisher Validierungsstudien an pädiatrischen Patienten. Ziel dieser Untersuchung war die Validierung von US gestützten Messungen der Knorpeldicke vorgegebener Gelenken in einer Gruppe gesunder Kinder anhand des Vergleichs mit der MRT. Material und Methoden: 25 gesunde kaukasische Kinder (17 Jungen, 8 Mädchen), mittleres Alter 11,33 Jahre, wurden mittels MRT (1,5 T, fettsupprimierte T 1-gewichtete 3-D-Sequenzen) und US (Real-time Hitachi EUB 6500 CFM, B-mode, 6 – 14 MHz Linearschallkopf) am rechten Knie, Fußgelenk, Handgelenk, metakarpophalangealen (MCP) und proximalen interphalangealen (PIP) Gelenken untersucht. Der US wurde entsprechend der EULAR-Kriterien durchgeführt. Ergebnisse: Alle Unterschiede zwischen US und MRT bezüglich der Knorpeldicke betrugen weniger als 0,5 mm. Der Variationskoeffizient war mit 16 % gut mit Ausnahme der Messungen am Handgelenk (20 %). Schlussfolgerung: Für Knorpeldickemessungen konnten wir eine gute Übereinstimmung und keine systematischen, von der Gelenkgröße abhängigen Unterschiede im Vergleich von MRT und US zeigen. Der US erweist sich zur Beurteilung der Knorpeldicke in von der JIA typischerweise betroffenen Gelenken als zuverlässig, insbesondere wenn alters- und geschlechtsspezifische Referenzwerte definiert sind.
Abstract
Purpose: In juvenile idiopathic arthritis (JIA), proliferative changes in the synovium and synovial fluid accumulation are pathological findings responsible for damage to the cartilaginous tissue and periarticular bone, which are late radiographic findings in conventional radiography. Early detection of these joint changes would allow the clinicians to initiate relevant therapies as is essential for the long-term outcome of JIA. Ultrasonography (US) has shown great potential for this purpose but validation in a pediatric setting is needed. The objective of this study was to validate US measurements of cartilage thickness in target joints in healthy children by comparing them with MRI. Materials and Methods: Twenty-five healthy Caucasian children (17 boys/ 8 girls), mean age 11.33 years, were examined with MRI (1.5 T, fat-suppressed T 1-weighted 3D sequences) and US (real-time Hitachi EUB 6500 CFM, B-mode 6 – 14 MHz linear transducer) in the right knee, ankle, wrist, metacarpophalangeal (MCP) and proximal interphalangeal (PIP) joints. US was obtained according to the EULAR standard scans. Results: All differences in cartilage thickness measurements between MRI and US were less than 0.5 millimeters. The coefficient of variation (CV) was found to be good (16 %) except for in the case of the wrist joint (20 %). Conclusion: We found a good level of agreement and no significant systematic joint size-related differences in cartilage thickness measurements between MRI and US. US appears to be a feasible method for evaluating cartilage thickness in JIA target joints, especially when age and sex-related references are defined.
Key words
ultrasound - MR imaging - cartilage - children - validation
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Dr. Anne Helene Spannow
Pediatric, Aarhus University Hospital, Skejby
Brendstrupgaardsvej 100
8200 Aarhus
Denmark
Phone: ++ 45/8 94 96 77 0
Fax: ++ 45/8 94 96 51 3
Email: spannow@ki.au.dk