Department of Radiology, Saint-Antoine Hospital, Sorbonne University, Paris, France.
Institute of Sports Imaging, French National Institute of Sports (INSEP), 11 Avenue du Tremblay, 75012, Paris, France.
Eur Radiol. 2021 Sep;31(9):6810-6815. doi: 10.1007/s00330-021-07785-1. Epub 2021 Mar 19.
OBJECTIVE: To compare the diagnostic performance of two different sets of magnetic resonance imaging (MRI) for the detection of subchondral erosions in the sacroiliac joints regarding the application of fat-water separation techniques when acquiring T1-weighted (T1w) images, using multi-detector computed tomography (MDCT) as the reference standard. METHODS: We retrospectively included 31 consecutive patients having or being suspected for axial spondyloarthritis (SpA) assessed using both MRI and MDCT. Three sets of images were independently assessed for the presence of erosions by two musculoskeletal radiologists (R1, R2): (1) MRI with standard T1w without fat suppression, (2) MRI with both T1w with and without fat suppression, and (3) MDCT. The diagnostic performance of both sets of MRIs was assessed using MDCT as the referent. RESULTS: The assessment of T1w images with fat suppression substantially increased sensitivity (76% vs. 63% R1; 70% vs. 60% R2), specificity (97% vs. 84% R1; 96% vs. 81% R2), positive predictive value (85% vs. 45% R1; 81% vs. 40% R2), and overall accuracy (94% vs. 80% R1; 92% vs. 77% R2) in the detection of erosions when compared to the assessment using T1w images without fat suppression. CONCLUSION: The assessment of T1w images with fat suppression substantially improves the diagnostic performance of MRI in the detection of erosions in the sacroiliac joints. KEY POINTS: • The presence of erosions in the sacroiliac joints may influence the decision on the diagnosis of axial spondyloarthritis. • T1w fat-suppressed MR imaging relatively increases the contrast between the joint space (high signal) and the adjacent subchondral bone (low signal), potentially improving the detection of erosions in the sacroiliac joints. • T1w fat-suppressed images improve the diagnostic performance of MRI in the detection of erosions in the sacroiliac joints compared to T1w without fat suppression, using MDCT as the reference.
目的:比较两种不同的磁共振成像(MRI)方案在检测骶髂关节骨侵蚀方面的诊断性能,这些方案在采集 T1 加权(T1w)图像时应用了水脂分离技术,以多排螺旋 CT(MDCT)作为参考标准。
方法:我们回顾性纳入了 31 例连续患者,这些患者或疑似患有中轴型脊柱关节炎(SpA),并接受了 MRI 和 MDCT 检查。两名肌肉骨骼放射科医生(R1、R2)分别对存在侵蚀的 3 组图像进行了独立评估:(1)标准 T1w 序列,不使用脂肪抑制;(2)T1w 序列,同时使用和不使用脂肪抑制;(3)MDCT。使用 MDCT 作为参照,评估两种 MRI 方案的诊断性能。
结果:使用脂肪抑制的 T1w 图像评估显著提高了敏感度(R1:76%比 63%;R2:70%比 60%)、特异性(R1:97%比 84%;R2:96%比 81%)、阳性预测值(R1:85%比 45%;R2:81%比 40%)和整体准确性(R1:94%比 80%;R2:92%比 77%)。
结论:在检测骶髂关节侵蚀方面,使用脂肪抑制的 T1w 图像评估显著提高了 MRI 的诊断性能。
关键点:
Curr Rheumatol Rep. 2022-6