Data-Driven Magnetic Resonance Imaging Definitions for Active and Structural Sacroiliac Joint Lesions in Juvenile Spondyloarthritis Typical of Axial Disease: A Cross-Sectional International Study.
Data-Driven Magnetic Resonance Imaging Definitions for Active and Structural Sacroiliac Joint Lesions in Juvenile Spondyloarthritis Typical of Axial Disease: A Cross-Sectional International Study.
复制标题
轴性疾病典型的青少年脊柱关节炎的活动性和结构性骶髂关节病变的数据驱动磁共振成像定义：一项横断面国际研究。
DOI：
10.1002/acr.25014
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发表时间：
2023
影响因子：
4.7
通讯作者：
Maksymowych,WalterP
中科院分区：
文献类型：
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作者：
Weiss,PamelaF;Brandon,TimothyG;Lambert,RobertG;Biko,DavidM;Chauvin,NancyA;Francavilla,MichaelL;Jaremko,JacobL;Herregods,Nele;Kasapcopur,Ozgur;Yildiz,Mehmet;Hendry,AlisonM;Maksymowych,WalterP
我们的目的是确定定量骶髂关节（SI）联合磁共振成像（MRI）截止的活动性和结构性病变，将被纳入为影像领域的分类标准的轴向疾病在青少年脊柱关节炎（SpA）methodsMRI扫描从国际横截面的青少年SpA患者进行了审查，由6名肌肉骨骼成像专家不知情的临床细节。评定者全面评估了是否存在轴向SpA的典型病变，并进行了SI关节象限或基于关节的评分。使用评估者多数（6名评估者中≥4名）对是否存在轴位SpA典型的活动性或结构性病变进行总体评估，计算病变临界值的灵敏度和特异性，并以高置信度作为参考标准。截止值进行了验证，在一个独立的cohol.Results243例，61%的男性，中位年龄14.9岁，成像序列可用于详细的MRI评分。定义幼年SpA中轴性疾病典型病变的最佳临界值为：1）炎性病变：所有SI关节MRI切片中≥3个SI关节象限的骨髓水肿（敏感性98.6%，特异性96.5%）; 2）结构性病变：在所有SI关节MRI切片中，≥3个象限的侵蚀或≥2个SI关节象限的硬化或脂肪病变或≥2个半关节的回填或强直敏感性98.6%，特异性95.5%。灵敏度和特异性的最佳cutoffs在validationcohol.ConclusionWe提出的数据驱动的cutoffs的活动性炎症和结构性病变的MRI典型的轴向疾病在青少年SpA，具有较高的特异性和敏感性，使用中央成像全球评估作为参考标准和良好的可靠性。
ObjectiveWe aimed to determine quantitative sacroiliac (SI) joint magnetic resonance imaging (MRI) cutoffs for active and structural lesions that will be incorporated as imaging domains in classification criteria of axial disease in juvenile spondyloarthritis (SpA).MethodsMRI scans from an international cross‐section of juvenile SpA patients were reviewed by 6 musculoskeletal imaging experts blinded to clinical details. Raters globally assessed the presence/absence of lesions typical of axial SpA and performed SI joint quadrant‐ or joint‐based scoring. Sensitivity and specificity of lesion cutoffs were calculated using a rater majority (≥4 of 6 raters) on a global assessment of the presence/absence of active or structural lesions typical of axial SpA with high confidence as the reference standard. Cutoffs were validated in an independent cohort.ResultsImaging from 243 subjects, 61% male, median age 14.9 years, had sequences available for detailed MRI scoring. Optimal cutoffs for defining lesions typical of axial disease in juvenile SpA were: 1) inflammatory lesion: bone marrow edema in ≥3 SI joint quadrants across all SI joint MRI slices (sensitivity 98.6%, specificity 96.5%); 2) structural lesions: erosion in ≥3 quadrants or sclerosis or fat lesion in ≥2 SI joint quadrants or backfill or ankylosis in ≥2 joint halves across all SI joint MRI slices (sensitivity 98.6%, specificity 95.5%). Sensitivity and specificity of the optimal cutoffs in the validation cohort were excellent.ConclusionWe propose data‐driven cutoffs for active inflammatory and structural lesions on MRI typical of axial disease in juvenile SpA that have high specificity and sensitivity using central imaging global assessment as the reference standard and excellent reliability.