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Jaw MRI Appears to Reliably Assess Synovitis in Patients With JIA
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An MRI pixel intensity ratio of 1.55 between the temporomandibular joint synovium and the longus capitis muscle can differentiate patients with juvenile idiopathic arthritis vs. children without inflammatory arthritis with a sensitivity of 91% and a specificity of 96%, according to recent findings.
“Our group has developed a simple and reliable method for quantifying synovial enhancement, which is representative of disease activity, within the temporomandibular joints of children with juvenile idiopathic arthritis,” Cory M. Resnick, DMD, MD, from Boston Children’s Hospital and Harvard School of Dental Medicine, told Healio Rheumatology.
Resnick and colleagues performed a retrospective case-control study of children who had MRIs with gadolinium including temporomandibular joints. The researchers divided patients into a juvenile idiopathic arthritis (JIA) group (n = 187) and a control group (n = 142). Using a coronal T1-weighted image, the researchers calculated an enhancement ratio of the average pixel intensity within three 0.2-mm2 regions of interest in the temporomandibular joint synovium to that of a 50-mm2 region of interest in the longus capitis muscle. To determine sensitivity and specificity, they used receiver-operating characteristic curves. To evaluate the inter-examiner and intra-examiner reliability, they used Bland-Altman plots and two-way mixed, absolute agreement intra-class correlation coefficients.
The researchers found an enhancement ratio threshold of 1.55 had a sensitivity of 91% and a specificity of 96%. They also reported the inter-examiner and intra-examiner reliability to be “excellent.”
“This will improve our ability to diagnose, manage and longitudinally follow patients with this elusive disease,” Resnick said. – by Will Offit
Disclosure: The researchers report no relevant financial disclosures.
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