Bollow M, Braun J, Biedermann T, Mutze S, Paris S, Schauer-Petrowskaja C, Minden K, Schmitz S A, Schöntube M, Hamm B
Department of Radiology, Charité Campus Mitte, Humboldt-Universität zu Berlin, Germany.
Skeletal Radiol. 1998 Nov;27(11):606-16. doi: 10.1007/s002560050446.
To verify the diagnostic value of contrast-enhanced MR imaging compared with conventional radiography in the diagnosis of sacroiliitis in children.
Radiography and MR imaging of the sacroiliac joints were performed in 185 children subdivided into the following groups according to the modified European Spondyloarthropathy (SpA) Study Group (ESSG) criteria: group 1, undifferentiated spondyloarthropathy (uSpA) (n=53, 94.5% HLA-B27+); group 2, differentiated SpA (n=45, 93.3% HLA-B27+); group 3, patients with no signs of SpA other than oligoarthritis (n=39, 92.3% HLA-B27+); group 4, HLA-B27+ controls with various other non-SpA diagnoses (n=22); and group 5, HLA-B27-controls with various other non-SpA diagnoses (n=26). Radiographs were evaluated on the basis of the modified New York criteria independently by three experienced radiologists masked to the clinical data. In a second step, the same radiologists independently evaluated the MR images without knowledge of the clinical data and radiographic findings using the recently published criteria developed by our group. These criteria allow differentiation of acute and chronic inflammatory changes.
Radiography demonstrated sacroiliitis in 18 patients: 4 of 53 in group 1 (7.5%), 14 of 45 in group 2 (31%), but none in groups 3, 4 and 5. In contrast, MR imaging demonstrated acute and/or chronic sacroiliitis in 44 patients: 18 of 53 in group 1 (34%), 21 of 45 in group 2 (46.7%) and 5 of 39 in group 3 (12.8%), but none in groups 4 and 5. The percentage of sacroiliitis detected by MR imaging was significantly higher than that detected by radiography (P<0.001).
Contrast-enhanced MR imaging is a useful method for detecting sacroiliitis in children. Advantages of contrast-enhanced MR imaging compared with conventional radiography are a higher sensitivity due to the ability to document early and acute changes and the absence of radiation exposure.
验证对比增强磁共振成像（MR成像）相较于传统X线摄影在儿童骶髂关节炎诊断中的价值。
对185名儿童进行骶髂关节的X线摄影和MR成像检查，根据改良的欧洲脊柱关节病（SpA）研究组（ESSG）标准将其分为以下几组：第1组，未分化脊柱关节病（uSpA）（n = 53，94.5% HLA - B27阳性）；第2组，分化型SpA（n = 45，93.3% HLA - B27阳性）；第3组，除少关节炎外无SpA体征的患者（n = 39，92.3% HLA - B27阳性）；第4组，患有各种其他非SpA诊断的HLA - B27阳性对照者（n = 22）；第5组，患有各种其他非SpA诊断的HLA - B27阴性对照者（n = 26）。由三名对临床资料不知情的经验丰富的放射科医生根据改良的纽约标准独立评估X线片。第二步，同样的放射科医生在不了解临床资料和X线摄影结果的情况下，使用我们团队最近制定的标准独立评估MR图像。这些标准可区分急性和慢性炎症变化。
X线摄影显示18例患者存在骶髂关节炎：第1组53例中有4例（7.5%），第2组45例中有14例（31%），但第3、4和5组均无。相比之下，MR成像显示44例患者存在急性和/或慢性骶髂关节炎：第1组53例中有18例（34%），第2组45例中有21例（46.7%），第3组39例中有5例（12.8%），第4和5组均无。MR成像检测到的骶髂关节炎百分比显著高于X线摄影检测到的百分比（P < 0.001）。
对比增强MR成像是检测儿童骶髂关节炎的一种有用方法。与传统X线摄影相比，对比增强MR成像的优势在于能够记录早期和急性变化，敏感性更高，且无辐射暴露。
