Development of international consensus on a standardised image acquisition protocol for diagnostic evaluation of the sacroiliac joints by MRI: an ASAS-SPARTAN collaboration.

IF 20.3 1区 医学 Q1 RHEUMATOLOGY Annals of the Rheumatic Diseases Pub Date : 2024-08-06 DOI:10.1136/ard-2024-225882
Robert G W Lambert, Xenofon Baraliakos, Stephanie A Bernard, John A Carrino, Torsten Diekhoff, Iris Eshed, Kay Geert A Hermann, Nele Herregods, Jacob Jaremko, Lennart Bo Jans, Anne Grethe Jurik, John M D O'Neill, Monique Reijnierse, Michael J Tuite, Walter P Maksymowych
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Abstract

Background: A range of sacroiliac joint (SIJ) MRI protocols are used in clinical practice but not all were specifically designed for diagnostic ascertainment. This can be confusing and no standard diagnostic SIJ MRI protocol is currently accepted worldwide.

Objective: To develop a standardised MRI image acquisition protocol (IAP) for diagnostic ascertainment of sacroiliitis.

Methods: 13 radiologist members of Assessment of SpondyloArthritis International Society (ASAS) and the SpondyloArthritis Research and Treatment Network (SPARTAN) plus two rheumatologists participated in a consensus exercise. A draft IAP was circulated with background information and online examples. Feedback on all issues was tabulated and recirculated. The remaining points of contention were resolved and the revised IAP was presented to the entire ASAS membership.

Results: A minimum four-sequence IAP is recommended for diagnostic ascertainment of sacroiliitis and its differential diagnoses meeting the following requirements. Three semicoronal sequences, parallel to the dorsal cortex of the S2 vertebral body, should include sequences sensitive for detection of (1) changes in fat signal and structural damage with T1-weighting; (2) active inflammation, being T2-weighted with fat suppression; (3) bone erosion optimally depicting the bone-cartilage interface of the articular surface and (4) a semiaxial sequence sensitive for detection of inflammation. The IAP was approved at the 2022 ASAS annual meeting with 91% of the membership in favour.

Conclusion: A standardised IAP for SIJ MRI for diagnostic ascertainment of sacroiliitis is recommended and should be composed of at least four sequences that include imaging in two planes and optimally visualise inflammation, structural damage and the bone-cartilage interface.

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就磁共振成像诊断评估骶髂关节的标准化图像采集协议达成国际共识:ASAS-SPARTAN 合作。
背景:临床实践中使用了一系列骶髂关节(SIJ)磁共振成像方案,但并非所有方案都是专门为诊断确定而设计的。这可能会造成混淆,而且目前世界上还没有公认的标准骶髂关节 MRI 诊断方案:方法:国际脊柱关节炎评估协会(ASAS)和脊柱关节炎研究与治疗网络(SPARTAN)的 13 名放射科成员以及两名风湿病学家参与了一项共识活动。会上分发了附有背景资料和在线示例的 IAP 草案。对所有问题的反馈意见进行了列表并重新分发。剩余的争议点得到解决,修订后的 IAP 提交给了 ASAS 全体成员:结果:建议至少使用四序列 IAP 来诊断确定骶髂关节炎及其鉴别诊断,并满足以下要求。与 S2 椎体背侧皮质平行的三个半冠状序列应包括对以下情况敏感的序列:(1) 脂肪信号变化和 T1 加权的结构损伤;(2) 活动性炎症,T2 加权脂肪抑制;(3) 骨侵蚀,以最佳方式描述关节面的骨-软骨界面;(4) 对炎症敏感的半轴序列。IAP在2022年ASAS年会上获得批准,91%的成员赞成:结论:推荐用于骶髂关节磁共振成像诊断确定骶髂关节炎的标准化 IAP,应至少由四个序列组成,包括两个平面的成像,并能最佳地观察炎症、结构损伤和骨-软骨界面。
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来源期刊
Annals of the Rheumatic Diseases
Annals of the Rheumatic Diseases 医学-风湿病学
CiteScore
35.00
自引率
9.90%
发文量
3728
审稿时长
1.4 months
期刊介绍: Annals of the Rheumatic Diseases (ARD) is an international peer-reviewed journal covering all aspects of rheumatology, which includes the full spectrum of musculoskeletal conditions, arthritic disease, and connective tissue disorders. ARD publishes basic, clinical, and translational scientific research, including the most important recommendations for the management of various conditions.
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