Baraliakos Xenofon, Østergaard Mikkel, Lambert Robert Gw, Eshed Iris, Machado Pedro M, Pedersen Susanne Juhl, Weber Ulrich, de Hooge Manouk, Sieper Joachim, Poddubnyy Denis, Rudwaleit Martin, van der Heijde Désirée, Landewé Robert Bm, Maksymowych Walter P
Rheumazentrum Ruhrgebiet Herne, Ruhr-University Bochum, Bochum, Germany.
Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet, Glostrup and Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark.
Ann Rheum Dis. 2022 Aug 11;81(9):1243-1251. doi: 10.1136/annrheumdis-2021-222081.
Spinal MRI is used to visualise lesions associated with axial spondyloarthritis (axSpA). The ASAS MRI working group (WG) updated and validated the definitions for inflammatory and structural spinal lesions in the context of axSpA.
After review of the existing literature on all possible types of spinal MRI pathologies in axSpA, the group (12 rheumatologists and two radiologists) consented on the required revisions of lesion definitions compared with the existing nomenclature of 2012. In a second step, using 62 MRI scans from the ASAS classification cohort, the proposed definitions were validated in a multireader campaign by global (absent/present) and detailed (inflammation and structural) lesion assessment at the vertebral corner (VC), vertebral endplate, facet joints, transverse processes, lateral and posterior elements. Intraclass correlation coefficient (ICC) was used for analysis.
Revisions were made for both inflammatory (bone marrow oedema, BMO) and structural (fat, erosion, bone spur and ankylosis) lesions, including localisation (central vs lateral), extension (VC vs vertebral endplate) and extent (minimum number of slices needed), while new definitions were suggested for the type of lesion based on lesion maturity (VC monomorphic vs dimorphic). The most reliably assessed lesions were VC fat lesion and VC monomorphic BMO (ICC (mean of all 36 reader pairs/overall 9 readers): 0.91/0.92; 0.70/0.67, respectively.
The lesion definitions for spinal MRI lesions compatible with SpA were updated by consensus and validated by a group of experienced readers. The lesions with the highest frequency and best reliability were fat and monomorphic inflammatory lesions at the VC.
脊柱磁共振成像（MRI）用于观察与中轴型脊柱关节炎（axSpA）相关的病变。ASAS MRI工作组（WG）在axSpA背景下更新并验证了炎症性和结构性脊柱病变的定义。
在回顾了关于axSpA中所有可能类型的脊柱MRI病变的现有文献后，该小组（12名风湿病学家和2名放射科医生）就与2012年现有命名法相比所需的病变定义修订达成一致。第二步，使用来自ASAS分类队列的62份MRI扫描，通过多读者活动，在椎体角（VC）、椎体终板、小关节、横突、外侧和后部结构进行整体（无/有）和详细（炎症和结构）病变评估，对提议的定义进行验证。组内相关系数（ICC）用于分析。
对炎症性病变（骨髓水肿，BMO）和结构性病变（脂肪、侵蚀、骨赘和强直）均进行了修订，包括定位（中央与外侧）、范围（VC与椎体终板）和程度（所需的最小切片数），同时根据病变成熟度（VC单形性与双形性）对病变类型提出了新的定义。评估最可靠的病变是VC脂肪病变和VC单形性BMO（ICC（所有36对读者的平均值/总共9名读者）：分别为0.91/0.92；0.70/0.67）。
与SpA相关的脊柱MRI病变定义经共识更新，并由一组经验丰富的读者进行了验证。频率最高且可靠性最佳的病变是VC处的脂肪和单形性炎症性病变。
