Giraudo Chiara, Magnaldi Silvia, Weber Michael, Puchner Antonia, Platzgummer Hannes, Kainberger Franz, Schueller-Weidekamm Claudia
Division of Neuroradiology and Musculoskeletal Radiology, Department of Biomedical Imaging und Image-guided Therapy, Medical University of Vienna, Vienna General Hospital, Waehringer Guertel 18-20, Vienna, 1090, Austria.
Dipartimento di Radiologia e Diagnostica per Immagini, Fondazione Poliambulanza Istituto Ospedaliero, Brescia, Italy.
Eur Radiol. 2016 Jan;26(1):122-9. doi: 10.1007/s00330-015-3790-4. Epub 2015 Apr 28.
To assess the diagnostic value of para-axial T2w-TSE (paT2) and fat-suppressed proton density (paPD-FS) MRI sequences for the evaluation of the sacroiliac joint (SIJ) of patients with axial Spondylarthritis (SpA).
One hundred and six patients with clinical findings suggestive of SpA underwent an MR protocol of the SIJ with additional paPD-FS (41 patients) and paT2 (105 patients). Acute (bone marrow oedema [BME], enthesitis, capsulitis, synovitis) and chronic findings (erosions, ankylosis) were assessed by paPD-FS and compared with the gold standard post-contrast sequences, whereas chronic features (because of the lack of fat suppression) were evaluated on paT2 and compared with pcT1.
paPD-FS demonstrated high sensitivity (98.9 %) and specificity (99.1 %) for BME; sensitivity and specificity for synovitis and enthesitis were 100 %; 85.7 % and 100 %, respectively, for capsulitis. paPD-FS and paT2 showed 100 % sensitivity and specificity for ankylosis; for erosions, paT2 demonstrated 85.3 % sensitivity and 100 % specificity, whereas paPD-FS, respectively, 98 % and 100 %.
PaT2 and paPD-FS provided precious information enabling an accurate interpretation of the heterogeneous findings of SpA. paPD-FS showed good results in detecting acute and chronic lesions and its inclusion in a routine MR examination of the SIJ could increase the diagnostic performance of a pre-contrast protocol.
Para-axial sequence should be included in a routine MRI protocol for SpA. Acute and chronic findings can be evaluated on para-axial PD-FS. Para-axial PD-FS is superior to para-axial T2-W in SpA.
评估轴位T2加权快速自旋回波（paT2）和脂肪抑制质子密度（paPD-FS）MRI序列对轴性脊柱关节炎（SpA）患者骶髂关节（SIJ）评估的诊断价值。
106例有SpA临床症状的患者接受了SIJ的MR检查方案，其中41例患者还进行了paPD-FS序列检查，105例患者进行了paT2序列检查。通过paPD-FS评估急性（骨髓水肿[BME]、附着点炎、囊炎、滑膜炎）和慢性表现（侵蚀、强直），并与金标准增强后序列进行比较，而慢性特征（由于缺乏脂肪抑制）在paT2序列上进行评估，并与增强T1加权像（pcT1）进行比较。
paPD-FS对BME的敏感性为98.9%，特异性为99.1%；对滑膜炎和附着点炎的敏感性和特异性均为100%；对囊炎的敏感性和特异性分别为85.7%和100%。paPD-FS和paT2对强直的敏感性和特异性均为100%；对于侵蚀，paT2的敏感性为85.3%，特异性为100%，而paPD-FS的敏感性和特异性分别为98%和100%。
PaT2和paPD-FS提供了宝贵信息，有助于准确解读SpA的异质性表现。paPD-FS在检测急性和慢性病变方面效果良好，将其纳入SIJ的常规MR检查可提高平扫方案的诊断性能。
轴位序列应纳入SpA的常规MRI检查方案。急性和慢性表现可通过轴位PD-FS进行评估。在SpA中，轴位PD-FS优于轴位T2加权像。
