Fadli David, Lintingre Pierre-Francois, Dallet Laurence, Raoult Julien, Gay-Depassier Julien, Bouguennec Nicolas, Pesquer Lionel, Dallaudière Benjamin
Centre D'imagerie Ostéoarticulaire, Clinique du Sport, Bordeaux Mérignac, 2, rue Georges-Négrevergne, 33700 Mérignac, France.
Clinique du Sport de Bordeaux-Mérignac, 33700 Mérignac, France.
Bioengineering (Basel). 2025 May 9;12(5):502. doi: 10.3390/bioengineering12050502.
The aim of this study was to assess and compare the diagnostic accuracy of two MRI techniques for identifying structural bone lesions (fatty lesions [BMFs], subchondral erosions [BMEs], sclerosis [BMS], and ankylosis [A]) in the dorso-lumbar joints. This assessment specifically focused on the application of MRI Dixon sequence fat-water separation techniques (T2w Dixon FSTs) when acquiring T1-weighted (T1w) images as the reference standard, among patients diagnosed with axial spondyloarthritis (SpA).
Conducted at a single center, this study involved the recruitment of patients who underwent both spinal and sacroiliac (SI) joint MRI between 2019 and 2022, with follow-up continuing until 2023. In 2023, three independent readers reassessed the initial MRI datasets to evaluate specific radiological features of SpA. They recorded confidence estimates regarding the use of T2w Dixon FSTs when acquiring T1w images. The centralized MRI interpretations were then compared to established rheumatologic diagnoses.
A total of 73 patients (42 men and 31 women) were included in the study. The mean sensitivity, specificity, and accuracy of T2w Dixon FSTs (fat-only images) were at least 75%, 100%, and 96%, respectively, based on the 2023 assessment for all considered items. The diagnostic performance of T2w Dixon FSTs was comparable to that of T1w images.
The diagnostic performance of T2w Dixon FSTs (fat-only images) matched that of T1w images not only in assessing structural and fatty lesions, but also in the evaluation of subchondral erosions, sclerosis, and ankylosis in the dorso-lumbar joints of patients with a rheumatologic diagnosis of SpA. These findings suggest the potential avoidance of T1-weighted images when employing multi-parameter, multi-sequence imaging, such as the Dixon sequence.
本研究旨在评估和比较两种磁共振成像（MRI）技术在识别背腰关节结构性骨病变（脂肪性病变[BMF]、软骨下侵蚀[BME]、骨质硬化[BMS]和关节强直[A]）方面的诊断准确性。这项评估特别关注在获取T1加权（T1w）图像作为参考标准时，MRI Dixon序列脂肪-水分离技术（T2w Dixon FST）的应用，研究对象为被诊断患有中轴型脊柱关节炎（SpA）的患者。
本研究在单一中心进行，招募了2019年至2022年间接受脊柱和骶髂（SI）关节MRI检查的患者，并持续随访至2023年。2023年，三名独立阅片者重新评估了最初的MRI数据集，以评估SpA的特定放射学特征。他们记录了在获取T1w图像时使用T2w Dixon FST的置信度估计。然后将集中的MRI解读结果与既定的风湿病诊断结果进行比较。
本研究共纳入73例患者（42例男性和31例女性）。基于2023年对所有考虑项目的评估，T2w Dixon FST（仅脂肪图像）的平均敏感性、特异性和准确性分别至少为75%、100%和96%。T2w Dixon FST的诊断性能与T1w图像相当。
T2w Dixon FST（仅脂肪图像）的诊断性能不仅在评估结构性和脂肪性病变方面与T1w图像相当，而且在评估风湿病诊断为SpA的患者背腰关节的软骨下侵蚀、骨质硬化和关节强直方面也与T1w图像相当。这些发现表明，在采用多参数、多序列成像（如Dixon序列）时，可能无需使用T1加权图像。
