{
  "abstract": "Objectives: Standard MR imaging (MRI) for rheumatoid arthritis (RA) patients comprises a post-contrast T1-fat-saturated (T1FS + C) sequence to detect wrist synovitis and tenosynovitis. This study investigates whether non-contrast sequences can provide similar information to post-contrast imaging.\n\nMaterials and methods: Seventy-seven RA patients (F/M: 64/13; age: 61 ± 12 years) underwent MRI examination of the most symptomatic wrist on a 3.0-T system. Axial T1FS + C as well as proton-density imaging with fat-saturation (PDFS) and T2-weighted imaging with fat-saturation (T2FS) sequences were performed. Two radiologists independently scored synovitis and tenosynovitis severity on all sequences, using the rheumatoid arthritis magnetic resonance imaging scoring system (RAMRIS). Intra- and interclass correlation coefficients (ICCs) were assessed.\n\nResults: For synovitis severity scoring, PDFS was practically identical to T1FS + C, while T2FS overestimated synovitis severity by up to 19%. For synovitis severity, PDFS imaging correlated better with T1FS + C than T2FS imaging (ICC: Reader 1: 0.931 vs 0.897; Reader 2: 0.969 vs 0.948). For tenosynovitis severity, PDFS and T2FS both yielded higher tenosynovitis scores than T1FS + C ( p < 0.001). Compared to T1FS + C imaging, PDFS overestimated tenosynovitis severity by up to 39%, while T2FS overestimated tenosynovitis severity by up to 54%. For tenosynovitis severity, PDFS imaging correlated better with T1FS + C than T2FS imaging (ICC: Reader 1: 0.856 vs 0.731; Reader 2: 0.808 vs 0.800).\n\nConclusion: PDFS imaging had good (for tenosynovitis) to excellent (for synovitis) intra- and inter-reader reliability and provides comparable scoring to T1FS + C imaging when evaluating synovitis severity, though it tends to overestimate tenosynovitis severity. PDFS imaging can reasonably replace contrast-enhanced imaging for assessing wrist synovitis in RA patients.\n\nKey Points: Question Post-contrast imaging is recommended for evaluating synovitis and tenosynovitis in rheumatoid arthritis (RA) patients, though it involves higher cost, scan time, and discomfort.\n\nFindings Proton-density imaging with fat-saturation (PDFS) imaging had good to excellent intra- and inter-reader reliability for evaluating synovitis and tenosynovitis in RA wrists. Compared to post-contrast T1-fat-saturated (T1FS + C) imaging, PDFS imaging provides comparable semi-quantitative synovitis severity grading but tends to overestimate tenosynovitis severity.\n\nCritical relevance statement Post-contrast imaging for synovitis and tenosynovitis in RA patients involves discomfort, a longer time, and cost. PDFS imaging has good reliability and compares well with post-contrast imaging. In RA wrists, compared to T1FS+C imaging, PDFS imaging provides comparative semi-quantitative synovitis severity grading but tends to overestimate tenosynovitis severity.",
  "abstract_shown": true,
  "affiliations": [],
  "article_type": "research article",
  "arxiv": null,
  "author_total": 4,
  "authors": [
    {
      "name": "Su Wu"
    },
    {
      "name": "James Francis Griffith",
      "orcid": "0000-0001-5206-9382"
    },
    {
      "name": "João Dourado"
    },
    {
      "name": "Lai Shan Tam"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/a17fgccsjk9kr.bib",
  "cited_by": 0,
  "doi": "10.1186/s13244-026-02406-1",
  "fulltext_url": "https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13653001/?tool=EBI",
  "id": "a17fgccsjk9kr",
  "issns": [
    "1869-4101"
  ],
  "landing_url": "https://europepmc.org/article/PMC/PMC13653001",
  "language": "eng",
  "licence": "CC-BY",
  "licence_label": "CC BY",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "openalex",
      "2745|Rheumatoid Arthritis Research and Therapies"
    ]
  ],
  "openalex": "W7221136514",
  "pdf_url": "https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13653001/pdf/?tool=EBI",
  "pmcid": "PMC13653001",
  "pmid": null,
  "published": "2026-10-09",
  "publisher": "Springer Science and Business Media LLC",
  "ris": "https://research.draconitic.com/paper/a17fgccsjk9kr.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:17:29Z",
      "native_id": "PMC:PMC13653001",
      "source": "europepmc",
      "url": "https://europepmc.org/article/PMC/PMC13653001"
    },
    {
      "first_seen": "2026-10-30T12:20:33Z",
      "native_id": "10.1186/s13244-026-02406-1",
      "source": "crossref",
      "url": "https://link.springer.com/10.1186/s13244-026-02406-1"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "issn:1869-4101",
      "subfield": "imaging"
    }
  ],
  "title": "Proton-density fat-saturated non-contrast MR imaging is comparable to post-contrast MR imaging for revealing wrist synovitis",
  "title_text": "Proton-density fat-saturated non-contrast MR imaging is comparable to post-contrast MR imaging for revealing wrist synovitis",
  "type": "peer-reviewed",
  "updated_at": "2026-10-30T12:20:33Z",
  "url": "https://research.draconitic.com/paper/a17fgccsjk9kr",
  "venue": "Insights into imaging",
  "versions": []
}