MRI Unit, Radiology Department, HT Medica, Jaén, Spain.
Osatek Alta Tecnología Sanitaria S.A., Department of Magnetic Resonance Imaging, Hospital Galdakao-Usansolo, Galdakao, Spain.
Eur J Radiol. 2023 Jun;163:110793. doi: 10.1016/j.ejrad.2023.110793. Epub 2023 Mar 21.
The introduction of MRI was supposed to be a qualitative leap for the evaluation of Sacroiliac Joint (SIJ) in patients with Axial Spondyloarthropathies (AS). In fact, MRI findings such as bone marrow edema around the SIJ has been incorporated into the Assessment in SpondyloArthritis International Society (ASAS criteria). However, in the era of functional imaging, a qualitative approach to SIJ by means of conventional MRI seems insufficient. Advanced MRI sequences, which have successfully been applied in other anatomical areas, are demonstrating their potential utility for a more precise assessment of SIJ. Dixon sequences, T2-mapping, Diffusion Weighted Imaging or DCE-MRI can be properly acquired in the SIJ with promising and robust results. The main advantage of these sequences resides in their capability to provide quantifiable parameters that can be used for diagnosis of AS, surveillance or treatment follow-up. Further studies are needed to determine if these parameters can also be integrated into ASAS criteria for reaching a more precise classification of AS based not only on visual assessment of SIJ but also on measurable data.
磁共振成像（MRI）的引入本应是评估患有中轴型脊柱关节炎（Axial Spondyloarthropathies，AS）患者的骶髂关节（Sacroiliac Joint，SIJ）的一个质的飞跃。事实上，MRI 发现的诸如围绕 SIJ 的骨髓水肿等表现已经被纳入了脊柱关节炎评估国际协会（Assessment in SpondyloArthritis International Society，ASAS）标准。然而，在功能成像时代，通过常规 MRI 对 SIJ 进行定性评估似乎还不够。在其他解剖区域已经成功应用的高级 MRI 序列，正在展示其在更精确评估 SIJ 方面的潜在应用价值。Dixon 序列、T2 映射、扩散加权成像或 DCE-MRI 可以在 SIJ 中适当采集，具有有前途和稳健的结果。这些序列的主要优势在于它们能够提供可量化的参数，可用于诊断 AS、监测或治疗随访。需要进一步的研究来确定这些参数是否也可以纳入 ASAS 标准，以便不仅基于 SIJ 的视觉评估，而且还基于可测量的数据，对 AS 进行更精确的分类。
