Spondyloarthritis research consortium of Canada magnetic resonance Imaging index for assessment of sacroiliac joint inflammation in ankylosing spondylitis
Spondyloarthritis research consortium of Canada magnetic resonance Imaging index for assessment of sacroiliac joint inflammation in ankylosing spondylitis
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DOI：
10.1002/art.21445
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发表时间：
2005-10-15
期刊：
影响因子：
--
通讯作者：
Lambert, RGW
中科院分区：
文献类型：
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作者：
Maksymowych, WP;Inman, RD;Lambert, RGW
客观的。开发一种可行的基于磁共振成像（MRI）的强直性脊柱炎（AS）患者骶髂关节炎症评分系统，该系统需要最短的扫描时间，不需要对比增强，单独评估每个关节面的病变，并限制评分的骶髂关节图像数量。使用基于 T2 加权 STIR 序列上表示骨髓水肿的增加信号的评估的评分方法。多个读者在 2 个地点以随机顺序对 MRI 胶片进行盲目评估。通过组内相关系数（ICC）评估读者内和读者间的可靠性；通过效应大小和标准化反应平均值评估随机接受安慰剂：英夫利昔单抗 (3:8) 的 AS 患者的 24 周反应。比较了 STIR 和二亚乙基三胺五乙酸钆 (GdDTPA) 增强 MRI 序列的评分方法的可靠性和响应性。结果。我们扫描了 11 名患有临床活动性疾病的 AS 患者，以及另外 11 名随机接受英夫利昔单抗治疗试验的患者。总骶髂关节 STIR 评分的 ICC 范围为 0.90 至 0.98 (P < 0.00001)，来自 2 个站点的联合读者的观察者间 ICC 为 0.84 (P < 0.0001)。 STIR 的 ICC 变化分数 (ICC 0.53) 低于 Gd-DTPA 增强序列 (ICC 0.79)。尽管接受治疗（安慰剂：英夫利昔单抗）的患者中有三分之一出现明显融合，并且炎症评分较低，但反应性较差。结论。加拿大脊柱关节炎研究联盟 MRI 指数是测量 AS 患者骶髂关节炎症的可行且可重复的指数。
Objective. To develop a feasible magnetic resonance imaging (MRI)-based scoring system for sacroiliac joint inflammation in patients with ankylosing spondylitis (AS) that requires minimal scan time, does not require contrast enhancement, evaluates lesions separately at each articular surface, and limits the number of sacroiliac images that are scored.Methods. A scoring method based on the assessment of increased signal denoting bone marrow edema on T2-weighted STIR sequences was used. MRI films were assessed blindly in random order at 2 sites by multiple readers. Intra- and interreader reliability was assessed by intraclass correlation coefficient (ICC); the 24-week response of patients with AS randomized to placebo: infliximab (3:8) was assessed by effect size and standardized response mean. The reliability and responsiveness of the scoring method were compared for STIR and gadolinium diethylenetriaminepentaacetic (GdDTPA)-enhanced MRI sequences.Results. We scanned 11 patients with AS with clinically active disease and 11 additional patients randomized to the trial of infliximab therapy. ICC for total sacroiliac joint STIR score ranged from 0.90 to 0.98 (P < 0.00001) and interobserver ICC for combined readers from the 2 sites was 0.84 (P < 0.0001). ICC for change scores was lower for STIR (ICC 0.53) than for Gd-DTPA-enhanced sequences (ICC 0.79). Responsiveness was poor, although fusion was evident in one-third of patients who received treatment (placebo:infliximab) and inflammation scores were low.Conclusion. The Spondyloarthritis Research Consortium of Canada MRI index is a feasible and reproducible index for measuring sacroiliac joint inflammation in patients with AS.