Quantification of bone marrow edema in rheumatoid arthritis by using high-speed T2-corrected multiecho acquisition of 1 H magnetic resonance spectroscopy: a feasibility study

Objective To determine whether high-speed T2-corrected multiecho (HISTO) sequences can quantify bone marrow edema (BME) in the capitate bone in rheumatoid arthritis (RA), and whether the HISTO fat fraction (FF) reflects therapeutic effectiveness. Methods In this prospective study, 25 RA patients (19 women; average age, 45.08 ± 13.48 years) underwent 3.0-T MRI with HISTO at the baseline and after 4, 8, and 12 weeks of treatment. Rheumatoid factor (RF), erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), platelet (PLT) count, and 28-joint Disease Activity Score using ESR (DAS28-ESR) were recorded on the day of each MRI examination by a rheumatologist blinded to the MRI findings. In addition, 21 healthy subjects (15 women; age, 49.17 ± 6.56 years) underwent only the HISTO sequence at a single time point. Results HISTO FF values were significantly higher in the control group (74.5% ± 3.1%; range, 68.6–79.3%) than in the patient group (55.8% ± 17.7%; range, 15.6–79.0%) at the baseline (independent-samples t -test: t = 5.257, P = 0.000). The changes in HISTO FF and DAS28-ESR showed moderate negative correlations with each other at 4, 8, and 12 weeks, and all of them were statistically significant ( P < 0.05). As the HISTO FF increased, the DAS28-ESR decreased. Conclusion The HISTO sequence can measure the bone marrow FF of the wrist joint bones in RA patients. The HISTO FF value increased as the DAS28-ESR decreased. The HISTO sequence may help quantify BME in RA and help monitor the effectiveness of RA treatment. Key Points • The HISTO sequence could measure the bone marrow FF of the wrist joint bones . • FF value increased as the DAS28-ESR decreased in RA patients . • The HISTO sequence can monitor the therapeutic effect of RA .