Department of Radiology, Christian Medical College, Vellore, India.
Department of Diagnostic Imaging, Research Institute, The Hospital for Sick Children, Department of Medical Imaging, University of Toronto, Toronto, ON, Canada.
Semin Arthritis Rheum. 2021 Dec;51(6):1350-1359. doi: 10.1016/j.semarthrit.2021.07.017. Epub 2021 Aug 15.
Whole body-MRI is helpful in directing diagnostic and treatment approaches, and as a research outcome measure. We describe our initial consensus-driven phase towards developing a whole body-MRI scoring system for juvenile idiopathic arthritis.
An iterative approach using three rounds of anonymous Delphi surveys followed by a consensus meeting was used to draft the structure of the whole body-MRI scoring system, including the relevant anatomic joints and entheses for assessment, diagnostic item selection, definition and grading, and selection of appropriate MRI planes and sequences. The surveys were completed independently by an international expert group consisting of pediatric radiologists and rheumatologists.
Twenty-two experts participated in at least one of three rounds of Delphi surveys and a concluding consensus meeting. A first iteration scoring system was developed which ultimately included the assessment of 100 peripheral, 23 chest, and 76 axial joints, and 64 entheses, with 2-4 diagnostic items graded in each of the items, using binary (presence/absence) and 2-3-level ordinal scores. Recommendations on anatomic MRI planes and sequences were specified as the minimally necessary imaging protocol for the scoring system.
A novel whole body-MRI scoring system for juvenile idiopathic arthritis was developed by consensus among members of MRI in JIA OMERACT working group. Further iterative refinements, reliability testing, and responsiveness are warranted in upcoming studies.
全身 MRI 有助于指导诊断和治疗方法，并作为研究结果的衡量标准。我们描述了我们在开发幼年特发性关节炎全身 MRI 评分系统方面的初步共识驱动阶段。
采用三轮匿名 Delphi 调查和一次共识会议的迭代方法，起草全身 MRI 评分系统的结构，包括相关的解剖关节和附着点进行评估、诊断项目选择、定义和分级，以及选择适当的 MRI 平面和序列。该调查由由儿科放射科医生和风湿病学家组成的国际专家组独立完成。
22 名专家参加了至少一轮的三轮 Delphi 调查和一次总结性共识会议。制定了一个初步的评分系统，最终包括 100 个外周关节、23 个胸部关节和 76 个轴向关节以及 64 个附着点的评估，每个项目有 2-4 个诊断项目，使用二进制（存在/不存在）和 2-3 级序数评分进行分级。对解剖 MRI 平面和序列的建议被指定为评分系统的最小必要成像方案。
通过 MRI 在幼年特发性关节炎 OMERACT 工作组的成员之间达成共识，开发了一种新的幼年特发性关节炎全身 MRI 评分系统。在未来的研究中需要进一步进行迭代改进、可靠性测试和反应性测试。
