Bennett Alexander N, Marzo-Ortega Helena, Kaur-Papadakis Daljit, Rehman Amer
From the Academic Department of Military Rehabilitation, Defence Medical Rehabilitation Centre (DMRC), Headley Court, Epsom; UK National Institute for Health Research (NIHR) Leeds Musculoskeletal Biomedical Research Unit, Leeds Teaching Hospitals Trust and Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds; AbbVie Ltd., Maidenhead; Department of Radiology, Countess of Chester Hospital, Chester, UK.
A.N. Bennett, PhD, FRCP, Consultant Rheumatologist, Academic Department of Military Rehabilitation, DMRC, and NIHR Leeds Musculoskeletal Biomedical Research Unit, Leeds Teaching Hospitals Trust and Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds; H. Marzo-Ortega, LMS, MRCP, PhD, Consultant Rheumatologist, NIHR Leeds Musculoskeletal Biomedical Research Unit, Leeds Teaching Hospitals Trust and Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds; D. Kaur-Papadakis, PhD, Senior Medical Science Liaison, Rheumatology, AbbVie Ltd.; A. Rehman, MRCP, FRCR, Consultant Radiologist and Divisional Medical Director, Diagnostics and Pharmacy, Department of Radiology, Countess of Chester Hospital.
J Rheumatol. 2017 Jun;44(6):780-785. doi: 10.3899/jrheum.161337. Epub 2017 Apr 1.
Magnetic resonance imaging (MRI) is involved in the assessment of axial spondyloarthritis (axSpA); however, anecdotal evidence suggests diverse practice among radiologists. The objective of this study was to describe current practice in the use of MRI for assessment of axSpA by UK radiologists.
Six hundred ninety-nine UK radiologists were invited to complete an online survey. Availability of MR scanners, familiarity with axSpA disease-specific lesions, and MRI protocols and definitions of positive sacroiliac joint (SIJ) or spinal MRI were assessed.
Two-hundred sixty-nine radiologists (38%) from 131/180 (73%) acute UK National Health Service trusts/health boards responded. MRI waiting times < 2 months were reported by 90% of radiologists. Twenty-nine radiologists (11%) used contrast as standard, 256 (91%) used T1 and short-tau inversion recovery, and 172 (64%) also used T2 sequences. Five percent scanned only SIJ, 33% scanned SIJ and lumbar spine, 29% scanned SIJ and thoracolumbar spine, and 30% scanned SIJ and the whole spine. Mean scan time was 34 min. Eighteen percent did not use the subchondral bone marrow edema of the SIJ to help diagnose axSpA and 18% did not use the inflammatory vertebral corner lesions to assist diagnosis. Awareness of axSpA was reported by 75% of radiologists, and awareness of definitions for positive MRI of SIJ and spine by 31% and 25%, respectively.
These data highlight the need for better rheumatology-radiology collaboration on the identification of diagnostic axSpA MRI lesions and support the need for a consensus on the most appropriate MRI protocols for the assessment of axSpA.
磁共振成像（MRI）用于评估轴性脊柱关节炎（axSpA）；然而，有传闻证据表明放射科医生的做法存在差异。本研究的目的是描述英国放射科医生使用MRI评估axSpA的当前实践情况。
邀请699名英国放射科医生完成一项在线调查。评估了MR扫描仪的可用性、对axSpA疾病特异性病变的熟悉程度、MRI方案以及骶髂关节（SIJ）或脊柱MRI阳性的定义。
来自131/180（73%）英国急性国民健康服务信托基金/健康委员会的269名放射科医生（38%）做出了回应。90%的放射科医生报告MRI等待时间<2个月。29名放射科医生（11%）将造影剂作为标准使用，256名（91%）使用T1和短tau反转恢复序列，172名（64%）还使用T2序列。5%仅扫描SIJ，33%扫描SIJ和腰椎，29%扫描SIJ和胸腰椎，30%扫描SIJ和整个脊柱。平均扫描时间为3分钟。18%的医生不使用SIJ的软骨下骨髓水肿来辅助诊断axSpA，18%的医生不使用炎性椎体角病变来辅助诊断。75%的放射科医生报告了解axSpA，分别有31%和25%的医生了解SIJ和脊柱MRI阳性的定义。
这些数据凸显了在识别诊断axSpA的MRI病变方面加强风湿病学与放射学合作的必要性，并支持就评估axSpA最合适的MRI方案达成共识的必要性。
