RT Journal Article
SR Electronic
T1 Detection of Sacroiliitis by Short-tau Inversion Recovery and T2-weighted Turbo Spin Echo Sequences: Results from the SIMACT Study
JF The Journal of Rheumatology
JO J Rheumatol
FD The Journal of Rheumatology
SP 376
OP 383
DO 10.3899/jrheum.171425
VO 46
IS 4
A1 Juliane Greese
A1 Torsten Diekhoff
A1 Joachim Sieper
A1 Carsten Schwenke
A1 Marcus R. Makowski
A1 Denis Poddubnyy
A1 Bernd Hamm
A1 Kay Geert A. Hermann
YR 2019
UL http://www.jrheum.org/content/46/4/376.abstract
AB Objective. To compare proton density–weighted short-tau inversion recovery (PD-STIR) and T2-weighted fat-suppressed turbo spin echo (T2-FS) sequences for detecting osteitis lesions of the sacroiliac joints (SIJ) in patients with chronic low back pain (CLBP).Methods. This prospective study included 110 patients with CLBP and suspected spondyloarthritis and 18 healthy controls. All 128 participants (age range: 19–57 yrs) underwent 3.0 Tesla magnetic resonance imaging (MRI) of the SIJ including PD-STIR and T2-FS. Two readers independently scored PD-STIR and T2-FS images for osteitis in separate sessions. Sum scores and signal-to-noise (SNR) and contrast-to-noise (CNR) ratios were calculated. Images were further analyzed as to whether they fulfilled the Assessment of SpondyloArthritis international Society (ASAS) criterion of a positive MRI (MRI+). Interreader agreement was calculated using intraclass correlation coefficients.Results. Average osteitis sum scores were higher for T2-FS images (mean sum score of 4.10 in T2-FS vs 2.55 in PD-STIR, p = 0.017). Mean SNR was 16.54 for PD-STIR and 37.30 for T2-FS (p = 0.0289). Mean CNR was 4.14 for PD-STIR and 20.20 for T2-FS (p = 0.0212). For both readers, the ASAS MRI+ definition was more often fulfilled by T2-FS than by PD-STIR images, resulting in more patients being classified as having axial spondyloarthritis (axSpA): 68 patients using T2-FS versus 58 patients using PD-STIR. Interreader intraclass correlation coefficients were very good for both PD-STIR (0.91) and T2-FS (0.86).Conclusion. T2-FS sequences improve image quality and hence the detection of osteitis compared to the PD-STIR sequence. More patients were classified as axSpA based on a positive MRI by T2-FS.