Radiology and Diagnostic Imaging, University of Alberta, Edmonton, Alberta, Canada
Rheumazentrum Ruhrgebiet, Ruhr University Bochum, Herne, Germany.
Ann Rheum Dis. 2024 Nov 14;83(12):1628-1635. doi: 10.1136/ard-2024-225882.
A range of sacroiliac joint (SIJ) MRI protocols are used in clinical practice but not all were specifically designed for diagnostic ascertainment. This can be confusing and no standard diagnostic SIJ MRI protocol is currently accepted worldwide.
To develop a standardised MRI image acquisition protocol (IAP) for diagnostic ascertainment of sacroiliitis.
13 radiologist members of Assessment of SpondyloArthritis International Society (ASAS) and the SpondyloArthritis Research and Treatment Network (SPARTAN) plus two rheumatologists participated in a consensus exercise. A draft IAP was circulated with background information and online examples. Feedback on all issues was tabulated and recirculated. The remaining points of contention were resolved and the revised IAP was presented to the entire ASAS membership.
A minimum four-sequence IAP is recommended for diagnostic ascertainment of sacroiliitis and its differential diagnoses meeting the following requirements. Three semicoronal sequences, parallel to the dorsal cortex of the S2 vertebral body, should include sequences sensitive for detection of (1) changes in fat signal and structural damage with T1-weighting; (2) active inflammation, being T2-weighted with fat suppression; (3) bone erosion optimally depicting the bone-cartilage interface of the articular surface and (4) a semiaxial sequence sensitive for detection of inflammation. The IAP was approved at the 2022 ASAS annual meeting with 91% of the membership in favour.
A standardised IAP for SIJ MRI for diagnostic ascertainment of sacroiliitis is recommended and should be composed of at least four sequences that include imaging in two planes and optimally visualise inflammation, structural damage and the bone-cartilage interface.
临床实践中使用了多种骶髂关节（SIJ）MRI 方案，但并非所有方案都是专门为诊断确定而设计的。这可能会令人困惑，目前全球范围内还没有被广泛接受的标准诊断性 SIJ MRI 方案。
制定用于诊断确定骶髂关节炎的标准化 MRI 图像采集方案（IAP）。
13 名评估脊柱关节炎国际协会（ASAS）和脊柱关节炎研究与治疗网络（SPARTAN）的放射科医生成员以及两名风湿病学家参与了共识性研究。一份草案 IAP 与背景信息和在线示例一起发布。对所有问题的反馈进行了制表并重新发布。解决了剩余的争议点，并将修订后的 IAP 提交给了整个 ASAS 会员。
建议采用最小的四序列 IAP 进行骶髂关节炎及其鉴别诊断的诊断确定，符合以下要求。三个半冠状序列，与 S2 椎体背侧皮质平行，应包括用于检测以下方面变化的序列：（1）脂肪信号和结构损伤的 T1 加权；（2）活性炎症，T2 加权并带有脂肪抑制；（3）骨侵蚀，最佳显示关节表面的骨-软骨界面；（4）半轴向序列，对炎症敏感。该 IAP 在 2022 年 ASAS 年会上获得了 91%的会员支持而获得批准。
建议制定用于诊断确定骶髂关节炎的标准化 SIJ MRI IAP，该方案应由至少四个序列组成，包括两个平面的成像，并能最佳地显示炎症、结构损伤和骨-软骨界面。
