Lambert Robert G W, Tuite Michael J
Department of Radiology and Diagnostic Imaging, University of Alberta, Edmonton, AB, Canada.
Department of Radiology, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA.
Skeletal Radiol. 2025 Mar 6. doi: 10.1007/s00256-025-04899-1.
Imaging of the axial skeleton is a critical component of the diagnosis, management and follow-up of axial spondyloarthritis which may be difficult on clinical grounds and biological data alone. The sacroiliac joints (SIJ) are anatomically complex with high incidence of normal variation and degenerative change and techniques used to image the SIJ vary widely. Interpretation of MRI scans of the axial skeleton is facilitated by employing consistent protocols in which sequences are designed for the sensitive detection of inflammatory lesions, fat metaplasia and bone erosion. Considerable research has been undertaken in recent years to improve the accuracy of detection of these findings in early disease and detection of structural damage changes that would allow improvements in diagnosis and management of SpA patients. This review will examine recent advances in our understanding of axSpA and discuss innovations in MRI and CT, focusing on how to optimize a standard acquisition protocol for MRI of the SIJ, and discussing how to avoid some common technical pitfalls that may be encountered in MRI clinical practice.
中轴骨骼成像对于中轴型脊柱关节炎的诊断、管理及随访至关重要，仅依据临床症状和生物学数据可能难以诊断。骶髂关节（SIJ）解剖结构复杂，正常变异和退行性改变发生率高，用于骶髂关节成像的技术差异很大。采用一致的方案有助于对中轴骨骼的MRI扫描进行解读，其中序列设计用于灵敏检测炎症性病变、脂肪化生和骨质侵蚀。近年来开展了大量研究，以提高早期疾病中这些表现的检测准确性，以及检测结构损伤变化，从而改善脊柱关节炎（SpA）患者的诊断和管理。本综述将探讨我们对中轴型脊柱关节炎（axSpA）认识的最新进展，并讨论MRI和CT的创新之处，重点关注如何优化骶髂关节MRI的标准采集方案，以及讨论如何避免MRI临床实践中可能遇到的一些常见技术陷阱。
