Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA.
Eur Radiol. 2011 May;21(5):1050-7. doi: 10.1007/s00330-010-1994-1. Epub 2010 Oct 29.
To test the hypothesis that MR imaging guided triamcinolone acetonide injection into the sacroiliac joints of children with enthesitis-related arthritis is feasible, accurate and safe; and effectively reduces sacroiliac inflammation and disease progression.
A retrospective analysis of 14 children (6/14 [43%] female, 8/14 (57%) male; mean age, 13.2 years; range, 6-16 years) who received MR imaging guided sacroiliac joint injections at 0.2 Tesla or 1.5 Tesla for enthesitis-related arthritis and acute sacroilitis refractory to medical therapy was performed. 20 mg triamcinolone acetonide were injected. Assessed were intra-articular drug delivery; image quality, duration, and complications. Success of therapy was defined by change of sacroiliac inflammation. Remission time and erosions were assessed by follow-up MRI (range, 10-22 months).
Twenty four procedures resulted in intra-articular injection. Image quality was sufficient. No complications occurred. Procedure time was 40 min. Sedation time was 22 min. Success of therapy was achieved in 11/14 (79%) children. Sacroiliac inflammation decreased significantly (-59%). Median remission time was 13.7 months. No erosions occurred.
MR imaging guided steroid injection of the sacroiliac joints is feasible, accurate, and safe and can effectively reduce sacroiliac inflammatory activity and may therefore aid in the prevention of disease progression.
验证磁共振（MR）成像引导下将曲安奈德丙酮酸盐注射到附着点关节炎患儿的骶髂关节中是否可行、准确和安全；并有效减轻骶髂关节炎症和疾病进展。
对 14 名（43%为女性，6/14；57%为男性，8/14；平均年龄 13.2 岁；范围 6-16 岁）接受 MR 成像引导下骶髂关节注射治疗附着点关节炎和急性药物难治性骶髂关节炎的儿童进行回顾性分析。注射 20mg 曲安奈德丙酮酸盐。评估关节内药物输送、图像质量、持续时间和并发症。通过骶髂炎症的变化来定义治疗的成功。通过随访 MRI（范围 10-22 个月）评估缓解时间和侵蚀情况。
24 次手术均实现了关节内注射。图像质量良好。无并发症发生。手术时间为 40 分钟，镇静时间为 22 分钟。14 名儿童中有 11 名（79%）治疗成功。骶髂炎症显著降低（-59%）。中位缓解时间为 13.7 个月。未发生侵蚀。
MR 成像引导下骶髂关节类固醇注射是可行、准确和安全的，可以有效减轻骶髂关节炎症活动，从而有助于预防疾病进展。
