Vitor Faeda Dalto1, Rodrigo Luppino Assad2, Michel Daoud Crema3,4,5, Paulo Louzada-Junior6, Marcello Henrique Nogueira-Barbosa7. 1. Division of Radiology, Department of Internal Medicine, Ribeirao Preto Medical School, University of Sao Paulo, Avenida Bandeirantes, 3900 - Monte Alegre, Zip Code: 14048-900, Ribeirão Preto, SP, Brazil. fdalto@gmail.com. 2. Division of Clinical Imunology, Department of Internal Medicine, Ribeirao Preto Medical School, University of Sao Paulo, Avenida Bandeirantes, 3900 - Monte Alegre, Zip Code: 14048-900, Ribeirão Preto, SP, Brazil. 3. Service de Radiologie, Hôpital Saint-Antoine, Université Paris VI, Paris, France. 4. Department of Radiology, Quantitative Imaging Center, Boston University School of Medicine, Boston, MA, USA. 5. Departamento de Radiologia, Hospital do Coração (HCor) e Teleimagem, São Paulo, SP, Brazil. 6. Department of Internal Medicine, Ribeirao Preto Medical School, University of Sao Paulo, Avenida Bandeirantes, 3900 - Monte Alegre, Zip Code: 14048-900, Ribeirão Preto, SP, Brazil. 7. Division of Radiology, Department of Internal Medicine, Ribeirao Preto Medical School, University of Sao Paulo, Avenida Bandeirantes, 3900 - Monte Alegre, Zip Code: 14048-900, Ribeirão Preto, SP, Brazil.
Abstract
OBJECTIVE: To compare short tau inversion-recovery (STIR) with another fat saturation method in the assessment of sacroiliac joint inflammation. METHODS: This prospective cross-sectional study comprised 76 spondyloarthritis (SpA) patients who underwent magnetic resonance imaging of the sacroiliac joints in a 1.5-T scanner, using STIR, spectral attenuated inversion recovery (SPAIR) T2w and spectral presaturation with inversion recovery (SPIR) T1w post-contrast sequences. Two independent readers (R1 and R2) assessed the images using the Spondyloarthritis Research Consortium of Canada (SPARCC) score. We assessed agreement of the SPARCC scores for SPAIR T2w and STIR with that for T1 SPIR post-contrast (reference standard) using the St. Laurent coefficient. We evaluated each sequence using the concordance correlation coefficient (CCC). RESULTS: We observed a strong agreement between STIR and SPAIR T2w sequences. Lin's CCC was 0.94 for R1 and 0.84 for R2 for STIR and 0.94 for R1 and 0.84 for R2 for SPAIR. The interobserver evaluation revealed a good CCC of 0.79 for SPAIR and 0.78 for STIR. CONCLUSION: STIR technique and SPAIR T2w sequence showed high agreement in the evaluation of sacroiliac joint subchondral bone marrow oedema in patients with SpA. SPAIR T2w may be an alternative to the STIR sequence for this purpose. KEY POINTS: • There are no studies evaluating which fat saturation technique should be used. • SPAIR T2w may be an alternative to STIR for sacroiliac joint evaluation. • The study will lead to changes in guidelines for spondyloarthritis.
OBJECTIVE: To compare short tau inversion-recovery (STIR) with another fat saturation method in the assessment of sacroiliac joint inflammation. METHODS: This prospective cross-sectional study comprised 76 spondyloarthritis (SpA) patients who underwent magnetic resonance imaging of the sacroiliac joints in a 1.5-T scanner, using STIR, spectral attenuated inversion recovery (SPAIR) T2w and spectral presaturation with inversion recovery (SPIR) T1w post-contrast sequences. Two independent readers (R1 and R2) assessed the images using the Spondyloarthritis Research Consortium of Canada (SPARCC) score. We assessed agreement of the SPARCC scores for SPAIR T2w and STIR with that for T1 SPIR post-contrast (reference standard) using the St. Laurent coefficient. We evaluated each sequence using the concordance correlation coefficient (CCC). RESULTS: We observed a strong agreement between STIR and SPAIR T2w sequences. Lin's CCC was 0.94 for R1 and 0.84 for R2 for STIR and 0.94 for R1 and 0.84 for R2 for SPAIR. The interobserver evaluation revealed a good CCC of 0.79 for SPAIR and 0.78 for STIR. CONCLUSION: STIR technique and SPAIR T2w sequence showed high agreement in the evaluation of sacroiliac joint subchondral bone marrow oedema in patients with SpA. SPAIR T2w may be an alternative to the STIR sequence for this purpose. KEY POINTS: • There are no studies evaluating which fat saturation technique should be used. • SPAIR T2w may be an alternative to STIR for sacroiliac joint evaluation. • The study will lead to changes in guidelines for spondyloarthritis.
Entities:
Keywords:
Magnetic resonance imaging; Sacroiliitis; Spondylarthritis; Spondylitis; ankylosing
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