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Localized scleroderma: multiparametric MRI with diffusion-weighted imaging and gadolinium-based perfusion imaging for
Alex Iancau1, Sarah Attia1, Priya Sarlashkar1
1Medical School, University of Texas Southwestern Medical Center, Dallas, TX, USA.
Skeletal Radiology
|June 6, 2025
Summary
Multiparametric MRI (MPMRI) shows promise for assessing morphea activity. Perfusion and delayed enhancement correlate with active disease, offering a valuable tool beyond conventional MRI for evaluating morphea.
Area of Science:
- Radiology
- Medical Imaging
- Dermatology
Background:
- Conventional MRI has limitations in assessing morphea disease activity.
- Multiparametric MRI (MPMRI) offers advanced imaging techniques for evaluation.
Purpose of the Study:
- To explore the utility of MPMRI in assessing morphea disease activity.
- To correlate MRI findings with clinical assessment of morphea.
Main Methods:
- Retrospective study of 35 morphea patients using MRI with diffusion-weighted imaging (DWI) and perfusion techniques.
- Independent assessment of lesion extent and activity by three radiologists.
- Correlation of MRI findings with Physician Global Assessment (PGA).
Main Results:
- Active morphea lesions showed increased perfusion and delayed enhancement (71% of cases).
- Active lesions had significantly higher PGA scores compared to inactive lesions.
- Diffusion-weighted imaging (DWI) showed trends but had poor inter-reader reliability for ADC values.
Conclusions:
- MPMRI is a promising tool for assessing morphea extent and activity, correlating with clinical evaluation.
- Perfusion and delayed enhancement are key indicators of active morphea.
- DWI's current utility in morphea assessment is limited due to variability.
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