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MRI assessment of bone marrow oedema in the sacroiliac joints of patients with spondyloarthritis: is the SPAIR T2w technique comparable to STIR?

  • Musculoskeletal
  • Published:
European Radiology Aims and scope Submit manuscript

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.

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Abbreviations

AS:

Ankylosing spondylitis

ASAS:

Assessment of SpondyloArthritis International Society

BME:

Bone marrow oedema

CCC:

Concordance correlation coefficient

EA:

Enteropathic arthritis

EI:

Undifferentiated spondyloarthritis

ID:

Inversion delay

MRI:

Magnetic resonance imaging

PA:

Psoriatic arthritis

ReA:

Reactive arthritis

SpA:

Spondyloarthritis

SPAIR:

Spectral attenuated inversion recovery

SPIR:

Spectral presaturation with inversion recovery

STIR:

Short tau inversion recovery

TE:

Echo time

TR:

Repetition time

TI:

Inversion time

SPARCC:

Spondyloarthritis Research Consortium of Canada

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Authors and Affiliations

  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

    Vitor Faeda Dalto & Marcello Henrique Nogueira-Barbosa

  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

    Rodrigo Luppino Assad

  3. Service de Radiologie, Hôpital Saint-Antoine, Université Paris VI, Paris, France

    Michel Daoud Crema

  4. Department of Radiology, Quantitative Imaging Center, Boston University School of Medicine, Boston, MA, USA

    Michel Daoud Crema

  5. Departamento de Radiologia, Hospital do Coração (HCor) e Teleimagem, São Paulo, SP, Brazil

    Michel Daoud Crema

  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

    Paulo Louzada-Junior

Authors
  1. Vitor Faeda Dalto
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  2. Rodrigo Luppino Assad
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  4. Paulo Louzada-Junior
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  5. Marcello Henrique Nogueira-Barbosa
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Corresponding author

Correspondence to Vitor Faeda Dalto.

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Guarantor

The scientific guarantor of this publication is Marcello Henrique Nogueira-Barbosa

Conflict of interest

The authors of this manuscript declare relationships with the following companies: Michel D. Crema is a stockholder of Boston Imaging Core Lab (BICL), LLC.

Vitor Faeda Dalto, Rodrigo Luppino Assad, Paulo Louzada-Junior and Marcello Henrique Nogueira-Barbosa have no potential conflicts of interest.

Funding

This study has received funding by Coordination for the Improvement of Higher Education Personnel (Capes), Financing of Studies and Projects (FINEP, 01/2006 ref. 0184/07) and Foundation to support the teaching, research and service (FAEPA/HCFMRP- 1728/2015).

Statistics and biometry

Pro-STAT kindly provided statistical advice for this manuscript.

Informed consent

Written informed consent was waived by the institutional review board.

Ethical approval

Institutional review board approval was obtained.

Methodology

• prospective

• cross-sectional study/observational

• performed at one institution

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Dalto, V.F., Assad, R.L., Crema, M.D. et al. MRI assessment of bone marrow oedema in the sacroiliac joints of patients with spondyloarthritis: is the SPAIR T2w technique comparable to STIR?. Eur Radiol 27, 3669–3676 (2017). https://doi.org/10.1007/s00330-017-4746-7

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  • DOI: https://doi.org/10.1007/s00330-017-4746-7

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