Dynamic 3D-MR-angiography for assessing XXXX of the hand--a feasibility study.

@entity1 @entity3231 @entity1333 @entity75 @entity603 @entity309 @entity2762
PURPOSE: To investigate highly temporally resolved MR-angiography (MRA) with time-resolved imaging with stochastic trajectories (TWIST) of the hand as supplementary tool for dynamic assessment of @entity603 and vascular pathologies in @entity309 . MATERIAL AND METHODS: A coronal dynamic TWIST-MRA-sequence (0.7 mm   0.7 mm   1.4 mm, temporal resolution 2.5s, time of acquisition 4 min) of the predominantly affected hand of 17 @entity1 with suspected @entity309 was acquired after contrast administration (Multihance, Bracco Imaging @entity3231 ) at 3T (Magnetom VERIO, 8-channel-knee-coil, Siemens Healthcare). As standard of reference, contrast enhanced non fat-saturated coronal and fat-saturated axial T1-w sequences were acquired. These static sequences and the dynamic TWIST-MRA-maximum-intensity-projections (MIP) were separately assessed by two readers in consensus, recording the number of @entity75 (wrist, intercarpal, metacarpophaleangal/proximal/distal interphalangeal joints), signs of @entity2762 and @entity1333 . Diagnostic confidence was rated (4-point-scale: 4=excellent; 1=non-diagnostic). Statistical significance was tested using the Wilcoxon-rank-sum-test. RESULTS: An insignificantly lower number of @entity75 (n=72 vs. 89; p=0.1) and only 3/9 cases with @entity2762 were identified by the TWIST-MRA. For detected lesions, diagnostic confidence was comparable (MRA: 3.64; static T1-w post contrast: 3.47). In @entity1 with high clinical activity dynamic MRA showed very early synovial enhancement. Only dynamic MRA detected 3 cases of @entity1333 (subsequently confirmed with digital-subtraction-angiography). CONCLUSION: TWIST-MRA facilitates fast detection of @entity603 . Although dynamic MRA of the hand is inferior to static contrast enhanced sequences in assessing the number of synovitic and @entity75 , its high temporal resolution allows for fast visual grading of disease activity and assessment of @entity1333 without additional contrast material application.
