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The purpose of this study was (1) to compare DIR MRI to conventional contrast-enhanced (CE) MRI for delineation of the synovium in the knee in children with juvenile idiopathic arthritis (JIA) and (2) to assess the agreement between DIR MRI and CE-MRI regarding maximal synovial thickness measurements.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>In this prospective study, 26 children with JIA who consecutively underwent 3.0-T knee MRI between January 2018 and January 2021 were included (presence of knee arthritis: 13 [50%]; median age: 14\u00a0years [interquartile range [IQR]: 11\u201317]; 14 girls). Median confidence to depict the synovium (0\u2013100\u00a0mm visual analogue scale; scored by 2 readers [consensus based]) was 88 (IQR: 79\u201397) for DIR MRI versus 100 (IQR: 100\u2013100) for CE-MRI (<jats:italic>p<\/jats:italic> value\u2009=\u2009&lt;\u2009.001). Maximal synovial thickness per child (millimeters; scored by 4 individual readers) on DIR MRI was greater (<jats:italic>p<\/jats:italic> value\u2009=\u2009&lt;\u2009.001) in the children with knee arthritis (2.4\u00a0mm [IQR: 2.1\u20133.1]) than in those without knee arthritis (1.4\u00a0mm [IQR: 1.0\u20131.6]). Good inter-technique agreement for maximal synovial thickness per child was observed (<jats:italic>r<\/jats:italic><jats:sub>s<\/jats:sub>\u2009=\u20090.93 [<jats:italic>p<\/jats:italic> value\u2009=\u2009&lt;\u2009.001]; inter-reader reliability: ICC DIR MRI\u2009=\u20090.87 [<jats:italic>p<\/jats:italic> value\u2009=\u2009&lt;\u2009.001], ICC CE-MRI\u2009=\u20090.90 [<jats:italic>p<\/jats:italic> value\u2009=\u2009&lt;\u2009.001]).\n<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusion<\/jats:title>\n                <jats:p>DIR MRI adequately delineated the synovium in the knee of children with JIA and enabled synovial thickness measurement similar to that of CE-MRI. Our results demonstrate that DIR MRI should be considered as a child-friendly alternative to CE-MRI for evaluation of synovitis in children with (suspected) JIA.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s13244-022-01299-0","type":"journal-article","created":{"date-parts":[[2022,10,20]],"date-time":"2022-10-20T09:02:43Z","timestamp":1666256563000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["Double inversion recovery MRI versus contrast-enhanced MRI for evaluation of knee synovitis in juvenile idiopathic arthritis"],"prefix":"10.1186","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4544-1235","authenticated-orcid":false,"given":"Floris","family":"Verkuil","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert","family":"Hemke","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"E. 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