ArticleSkeletal radiology2025
Localized scleroderma: multiparametric MRI with diffusion-weighted imaging and gadolinium-based perfusion imaging for assessing disease activity.
Article in Skeletal radiology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
objectiveConventional MRI has been used to evaluate morphea, but its role in assessing disease activity remains limited. This study explores the utility of multiparametric MRI (MPMRI) in assessing disease activity in morphea. MATERIALS AND
methodsThis retrospective study included 35 patients with morphea who underwent MRI with diffusion-weighted imaging (DWI) and perfusion techniques, including delayed post-contrast sequences. Most patients were female (n = 23, 65.7%) with a mean age of 39.1 years (± 15.7). Morphea subtypes included linear (n = 16), generalized (n = 10), En-Coup-de Sabre (n = 4), Parry Romberg (n = 2), and eosinophilic fasciitis (n = 3). Three musculoskeletal radiologists independently assessed lesion extent and activity, with findings correlated to the Physician Global Assessment (PGA) of clinical activity. Inter-reader agreement was assessed using weighted Conger's Kappa and Intraclass Correlation Coefficient (ICC).
resultsClinically active disease was present in 21 patients (60%), while 14 (40%) had inactive disease. Increased perfusion and delayed enhancement were noted in 15/21 (71%) active cases and absent in 10/14 (71%) inactive cases (P = 0.0181). Radiologist-classified active lesions had significantly higher PGA scores than inactive lesions (P = 0.016). Mean apparent diffusion coefficient (ADC) values were higher in active lesions (1.21 ± 0.72 × 10
conclusionMPMRI shows promise for assessing disease extent and activity in morphea, correlating with dermatologic assessment. Perfusion and delayed enhancement were associated with active disease, while DWI showed a nonsignificant trend and variability, limiting its current utility.
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