Detection of inflammatory sacroiliitis in children with magnetic resonance imaging: is gadolinium contrast enhancement necessary?
Detection of inflammatory sacroiliitis in children with magnetic resonance imaging: is gadolinium contrast enhancement necessary?
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DOI：
10.1002/art.39159
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发表时间：
2015-05
期刊：
影响因子：
--
通讯作者：
Chauvin NA
中科院分区：
文献类型：
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作者：
Weiss PF;Xiao R;Biko DM;Johnson AM;Chauvin NA
In adults, gadolinium contrast-enhancement does not add incremental value to fluid sensitive sequences for evaluation of bone marrow edema. This study aimed to determine if magnetic resonance imaging (MRI) contrast is necessary to assess lesions consistent with inflammatory sacroiliitis in children. Subjects with clinically suspected or diagnosed JSpA underwent pelvic MRI consisting of multiplanar fluid sensitive- and post-gadolinium T1-weighted fat saturated sequences including dedicated sacral imaging. Three radiologists independently evaluated the fluid-sensitive sequences, and later, the complete study (including post-contrast imaging). With post-contrast imaging as the reference standard we calculated the test properties of fluid sensitive sequences for depiction of acute and chronic findings consistent with sacroiliitis. Fifty-one subjects had a median age of 15 years and 57% were male. Nineteen subjects (22 joints) were diagnosed with sacroiliitis based on post-contrast imaging and none had synovitis in the absence of bone marrow edema. All 22 joints demonstrated bone marrow edema on both fluid sensitive- and post-gadolinium T1-weighted fat saturated sequences. Eighteen percent of joints with sacroiliitis had capsulitis, which was depicted on both non-contrast and post-contrast imaging. Fifty-nine percent of joints with sacroiliitis had synovitis on post-contrast imaging. Sensitivity, specificity, PPV and NPV of fluid-sensitive sequences for the detection of acute inflammatory lesions consistent with sacroiliitis using post-gadolinium imaging as the reference standard were excellent. Inter-rater reliability was substantial for all parameters. Fluid sensitive sequences are sufficient to detect acute and chronic lesions consistent with inflammatory sacroiliitis in children.
