Karatoprak Nur Betül, Özdemir Zeynep Maraş, Karatoprak Sinan, Kahraman Ayşegül Sağır, Karaca Leyla, Yolbaş Servet
Department of Radiology, Kayseri City Training and Research Hospital, Turkey.
Faculty of Medicine, Department of Radiology, İnönü University, Turkey.
J Belg Soc Radiol. 2024 Dec 12;108(1):111. doi: 10.5334/jbsr.3658. eCollection 2024.
This study aims to assess the performances of T1‑weighted (T1W) and T2‑weighted (T2W) Dixon sequences as replacements for the standard magnetic resonance imaging (MRI) protocol for diagnosing active and chronic sacroiliitis. This single‑centre, prospective study included 107 patients who underwent 3 Tesla MRIs. The patients with inflammatory low‑back pain (aged 18-50 years) were included. The exclusion criteria included pregnancy, pelvic infection/malignancy history, pelvic metal implants or foreign body artefacts. The imaging protocol comprised standard T1W and T2W fat‑saturated (T2W‑FS) sequences and T1W-T2W Dixon sequences. Active sacroiliitis signs were assessed by comparing T2W‑FS images with T2W Dixon water‑only (WO) images. Chronic sacroiliitis signs were evaluated by comparing the standard T1W sequence with T1W-T2W Dixon fat‑only (FO), in‑phase (IP) and out‑of‑phase (OP) images. The quantitative analysis involved calculating signal‑to‑noise ratios (SNRs) and contrast‑to‑noise ratios (CNRs) for bone marrow edema (BME) and periarticular fat deposition (PFD). Descriptive statistics, correlation, diagnostic performance tests and interobserver reliability tests were performed in the qualitative analysis. There were no statistically significant differences in BME detection between the T2W‑FS and T2W Dixon‑WO images. T2W Dixon exhibited significantly greater SNRs-CNRs than did the standard protocol for BME and periarticular fat deposition assessments. T1W-T2W Dixon imaging demonstrated sufficiently high diagnostic performance for detecting erosions, periarticular fat deposition and ankylosis compared with the standard protocol. The T2W Dixon sequence has the potential to replace the standard protocol, which would reduce acquisition time. However, we do not recommend the use of the T1W Dixon sequence in routine practice, since standard T1W images provide similar or superior results to T1W Dixon images.
本研究旨在评估T1加权（T1W）和T2加权（T2W）狄克逊序列替代标准磁共振成像（MRI）方案用于诊断活动性和慢性骶髂关节炎的性能。这项单中心前瞻性研究纳入了107例行3特斯拉MRI检查的患者。纳入了炎性下腰痛（年龄18 - 50岁）的患者。排除标准包括妊娠、盆腔感染/恶性肿瘤病史、盆腔金属植入物或异物伪影。成像方案包括标准T1W和T2W脂肪抑制（T2W - FS）序列以及T1W - T2W狄克逊序列。通过比较T2W - FS图像与T2W狄克逊仅水（WO）图像来评估活动性骶髂关节炎体征。通过比较标准T1W序列与T1W - T2W狄克逊仅脂肪（FO）、同相位（IP）和反相位（OP）图像来评估慢性骶髂关节炎体征。定量分析涉及计算骨髓水肿（BME）和关节周围脂肪沉积（PFD）的信噪比（SNRs）和对比噪声比（CNRs）。在定性分析中进行了描述性统计、相关性分析、诊断性能测试和观察者间可靠性测试。T2W - FS图像与T2W狄克逊WO图像在BME检测方面无统计学显著差异。在BME和关节周围脂肪沉积评估方面，T2W狄克逊序列的SNRs - CNRs显著高于标准方案。与标准方案相比，T1W - T2W狄克逊成像在检测侵蚀、关节周围脂肪沉积和强直方面表现出足够高的诊断性能。T2W狄克逊序列有可能替代标准方案，这将减少采集时间。然而，我们不建议在常规实践中使用T1W狄克逊序列，因为标准T1W图像提供的结果与T1W狄克逊图像相似或更优。
