Are contrast-enhanced and non-contrast MRI findings reflecting synovial inflammation in knee osteoarthritis: a meta-analysis of observational studies. Issue 2 (February 2020)

• Record Type: Journal Article
• Authors: Shakoor, D.; Demehri, S.; Roemer, F.W.; Loeuille, D.; Felson, D.T.; Guermazi, A.
• Is Part Of: Osteoarthritis and cartilage. Volume 28:Issue 2(2020)
• Page Start: 126
• Page End: 136
• Publication Date: 2020-02
• Subjects: Synovitis -- Histology -- Contrast-enhanced -- MRI -- Correlation; Osteoarthritis -- Periodicals; Cartilage -- Periodicals; Osteoarthritis -- Periodicals; Cartilage -- Periodicals; Arthrose -- Périodiques; Articulations -- Maladies -- Périodiques; 616.7223005
• DOI: 10.1016/j.joca.2019.10.008
• Languages: English
• ISSNs: 1063-4584

Abstract

Summary: Objective: To determine the correlation between knee synovitis assessed on contrast-enhanced (CE) and non-contrast enhanced (NCE) magnetic resonance imaging (MRI) with histology in patients with knee osteoarthritis. Methods: A comprehensive literature search was performed, and related articles published through July 2018 were extracted. Spearman correlation coefficients of MRI-based scores with histology reports were pooled using random effects model. To evaluate presence of publication bias, Egger test was performed. Results: Of 2377 identified records, eight studies consisting of 246 MRI exams were included. Two studies reported results of dynamic CE (DCE)-MRI examinations (81 knees) and two studies reported results of NCE-MRI. There were moderate positive correlations between CE-MRI scores and macroscopic ( r = 0.53 (95% Confidence Interval (CI):0.37–0.66), P < 0.001) as well as microscopic ( r = 0.56 (0.39–0.69), P < 0.001) histology. DCE-MRI were strongly correlated ( r = 0.71 (0.58–0.80), P -value<0.001), with microscopic histology reports, while the correlation for NCE-MRI was low positive ( r = 0.44 (0.20–0.63), P < 0.001). Meta-regression analysis showed that pooled correlation coefficients of DCE-MRI were significantly higher than CE-MRI (Slope = 0.29, SE = 0.13, P -value = 0.02). CE-MRI were also correlated with inflammatory infiltrate ( r = 0.42), while the correlations for cell number of synovial lining ( r = 0.27) and level of fibrosis ( r = 0.29, P < 0.001) were very low. Conclusion: Static and dynamic CE-MRI evaluation of knee synovitis were positively correlated with macroscopic and microscopic features of synovial membrane inflammation. Among the features of synovial tissue inflammation, CE-MRI scores correlated best with the inflammatory infiltrates of synovial tissue. Paucity of current evidence warrants further studies to assess performance of NCE-MRI on determining knee synovitis.