Department of Radiology, the Fifth Affiliated Hospital of Sun Yat-sen University, Zhuhai, China.
Department of Rheumatology and Immunology, the Fifth Affiliated Hospital of Sun Yat-sen University, Zhuhai, China.
Front Immunol. 2022 Sep 26;13:1000314. doi: 10.3389/fimmu.2022.1000314. eCollection 2022.
Our primary objective was to verify the hypothesis that synthetic magnetic resonance imaging (MRI) is similar to conventional MRI in detecting sacroiliac joint lesions in patients with axial spondyloarthritis (axSpA). A secondary objective was to assess the quantitative value of synthetic mapping in bone marrow edema (BME) and fat metaplasia.
A total of 132 axSpA patients who underwent synthetic and conventional MRI from October 2019 to March 2021 were included in this prospective study. Two independent readers visually evaluated active inflammatory (BME, capsulitis, enthesitis, and inflammation at site of erosion) and structural lesions (erosion, sclerosis, ankylosis, and fat metaplasia) of the sacroiliac joints on conventional and synthetic magnetic resonance (MR) images. In addition, T1, T2, and proton density (PD) values, which were generated by synthetic mapping, were used to further quantitatively evaluate BME and fat metaplasia. A McNemar test was used to compare the differences between the two methods in the detection of sacroiliac joint lesions. Intraclass correlation coefficients (ICCs) were used to assess the inter-reader consistency of quantitative values. Mann-Whitney tests were performed, and receiver operating characteristic (ROC) curves were created for all quantitative analyses.
There were no statistical difference between synthetic and conventional MRI in the detection of sacroiliac joint lesions (all -values 0.05). A total of 103 images of BME and 111 images of fat metaplasia were quantitatively evaluated using T1, T2, and PD values. The consistency of quantitative values among readers was good (ICC 0.903-0.970). T1 and T2 values were consistently higher in BME than in normal marrow ( < 0.001), but PD values were not significantly different ( = 0.830). T2 and PD values were higher in fat metaplasia than in normal marrow, but T1 values were lower ( 0.001). In the case of BME, T1 values had greater diagnostic efficiency [area under the curve (AUC) 0.99] than T2 values (AUC 0.78). There were no significant differences in the diagnostic efficiency of T1 (AUC 0.88), T2 (AUC 0.88), and PD (AUC 0.88) values in the case of fat metaplasia.
Synthetic MRI is as effective as conventional MRI in detecting sacroiliac joint lesions in patients with axSpA. Furthermore, synthetic mapping can accurately quantify BME and fat metaplasia.
我们的主要目的是验证以下假设，即合成磁共振成像（MRI）在检测患有中轴型脊柱关节炎（axSpA）的患者的骶髂关节病变方面与常规 MRI 相似。次要目的是评估合成图在骨髓水肿（BME）和脂肪化生中的定量价值。
本前瞻性研究共纳入 132 例于 2019 年 10 月至 2021 年 3 月接受合成和常规 MRI 的 axSpA 患者。两名独立的读者分别对常规和合成磁共振（MR）图像上的骶髂关节的活动性炎症（BME、囊膜炎、附着点炎和侵蚀部位炎症）和结构病变（侵蚀、硬化、强直和脂肪化生）进行视觉评估。此外，还使用合成映射生成的 T1、T2 和质子密度（PD）值进一步定量评估 BME 和脂肪化生。采用 McNemar 检验比较两种方法检测骶髂关节病变的差异。采用组内相关系数（ICC）评估定量值的读者间一致性。进行了 Mann-Whitney 检验，并为所有定量分析创建了接收者操作特征（ROC）曲线。
在检测骶髂关节病变方面，合成 MRI 与常规 MRI 之间无统计学差异（所有 - 值均>0.05）。使用 T1、T2 和 PD 值对总共 103 张 BME 图像和 111 张脂肪化生图像进行了定量评估。读者之间的定量值一致性良好（ICC 0.903-0.970）。BME 中的 T1 和 T2 值明显高于正常骨髓（<0.001），但 PD 值无明显差异（=0.830）。脂肪化生中的 T2 和 PD 值高于正常骨髓，但 T1 值较低（<0.001）。在 BME 中，T1 值的诊断效率[曲线下面积（AUC）0.99]大于 T2 值（AUC 0.78）。在脂肪化生中，T1 值（AUC 0.88）、T2 值（AUC 0.88）和 PD 值（AUC 0.88）的诊断效率无显著差异。
合成 MRI 在检测 axSpA 患者的骶髂关节病变方面与常规 MRI 同样有效。此外，合成映射可以准确地定量评估 BME 和脂肪化生。
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