Changes in articular synovial lining volume measured by magnetic resonance in a randomized, double-blind, controlled trial of intra-articular samarium-153 particulate hydroxyapatite for chronic knee synovitis

被引:13
作者
Clunie, GPR
Wilkinson, ID
Lui, D
Hall-Craggs, MA
Paley, MN
Edwards, JCW
Ell, PJ
机构
[1] UCL, Rheumatol Res Unit, London, England
[2] UCL, Dept Radiol, London, England
[3] UCL, Inst Nucl Med, London, England
关键词
radiation synovectomy; samarium-153 particulate hydroxyapatite; quantitative magnetic resonance; synovial lining;
D O I
10.1093/rheumatology/38.2.113
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Objective. Magnetic resonance techniques have recently been investigated as tools with which to monitor inflammatory joint disease. Our aim was to use a contrast-enhanced T1-weighted protocol to monitor the short-term changes in knee synovial lining volume in a double-blind, randomized, controlled trial of intra-articular samarium-153 particulate hydroxyapatite (Sm-153 PHYP). Methods. Twenty-four out-patients with chronic knee synovitis, from a cohort who had been recruited to a long-term clinical efficacy trial, were recruited for this study. Patients received either intra-articular Sm-153 PHYP combined with 40 mg triamcinolone hexacetonide or 40 mg intra-articular triamcinolone hexacetonide alone. Synovial lining volumes were calculated from three-dimensional T1-weighted contrast-enhanced images made before and after contrast enhancement with thresholding and pixel counting, immediately before and 3 months after treatment. Results. Paired pre- and post-treatment magnetic resonance data were obtained for 18/24 (75%) patients. There was no significant difference in mean pre-treatment synovial volume between the two treatment groups (139 vs 127 ml). A mean reduction in synovial lining volume was detected in the Sm-L53 PHYP/steroid-treated group (139 to 110 ml, P = 0.07) and in the steroid-treated group (127 to 58 ml, P < 0.001). The reduction was significantly greater in the steroid-treated group (-61% vs -23%, P < 0.05). Conclusions. Short-term changes in articular synovial lining in response to intra-articular treatment for chronic synovitis may be monitored by magnetic resonance imaging. After 3 months, a greater mean reduction in synovial lining volume had occurred in response to intraarticular steroid alone compared to combined Sm-153 PHYP/steroid injection.
引用
收藏
页码:113 / 117
页数:5
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