Comparing MRI and conventional radiography for the detection of structural changes indicative of axial spondyloarthritis in the ASAS cohort

医学 骶髂关节炎 射线照相术 轴性脊柱炎 队列 强直性脊柱炎 骶髂关节 放射科 核医学 分级(工程) 磁共振成像 内科学 工程类 土木工程
作者
Mikhail Protopopov,Fabian Proft,Stephanie Wichuk,Pedro M Machado,Robert G. Lambert,Ulrich Weber,Susanne Juhl Pedersen,Mikkel Østergaard,Joachim Sieper,Martin Rudwaleit,Xenofon Baraliakos,Walter P. Maksymowych,Denis Poddubnyy
出处
期刊:Rheumatology [Oxford University Press]
卷期号:62 (4): 1631-1635 被引量:5
标识
DOI:10.1093/rheumatology/keac432
摘要

To compare MRI and conventional radiography of SI joints for detection of structural lesions typical for axial spondyloarthritis (axSpA).Adult patients from the Assessment of SpondyloArthritis international Society (ASAS) cohort with symptoms suggestive of axSpA and both SI joint MRI and radiographs available for central reading were included. Radiographs were evaluated by three readers according to the modified New York (mNY) criteria grading system. The presence of structural damage on radiographs was defined as fulfilment of the radiographic mNY criterion and, additionally, a lower threshold for sacroiliitis of at least grade 2 unilaterally. MRI scans were assessed for the presence of structural changes indicative of axSpA by seven readers. Diagnostic performance [sensitivity, specificity, positive and negative predictive values (PPV and NPV) and positive and negative likelihood ratios (LR+ and LR-)] of MRI and radiographs (vs rheumatologist's diagnosis of axSpA) were calculated.Overall, 183 patients were included and 135 (73.7%) were diagnosed with axSpA. Structural lesions indicative of axSpA on MRI had sensitivity 38.5%, specificity 91.7%, PPV 92.9%, NPV 34.6%, LR+ 4.62 and LR- 0.67. Sacroiliitis according to the mNY criteria had sensitivity 54.8%, specificity 70.8%, PPV 84.1%, NPV 35.8%, LR+ 1.88 and LR- 0.64. Radiographic sacroiliitis of at least grade 2 unilaterally had sensitivity 65.2%, specificity 50.0%, PPV 78.6%, NPV 33.8%, LR+ 1.30 and LR- 0.69.Structural lesions of the SI joint detected by MRI demonstrated better diagnostic performance and better interreader reliability compared with conventional radiography.

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