title: Use of contrast-enhanced MR imaging to detect sacroiliitis in children.
abstract: OBJECTIVE
  To verify the diagnostic value of contrast-enhanced MR imaging compared with conventional radiography in the diagnosis of sacroiliitis in children.
  
  
  METHODS
  Radiography and MR imaging of the sacroiliac joints were performed in 185 children subdivided into the following groups according to the modified European Spondyloarthropathy (SpA) Study Group (ESSG) criteria: group 1, undifferentiated spondyloarthropathy (uSpA) (n=53, 94.5% HLA-B27+); group 2, differentiated SpA (n=45, 93.3% HLA-B27+); group 3, patients with no signs of SpA other than oligoarthritis (n=39, 92.3% HLA-B27+); group 4, HLA-B27+ controls with various other non-SpA diagnoses (n=22); and group 5, HLA-B27-controls with various other non-SpA diagnoses (n=26). Radiographs were evaluated on the basis of the modified New York criteria independently by three experienced radiologists masked to the clinical data. In a second step, the same radiologists independently evaluated the MR images without knowledge of the clinical data and radiographic findings using the recently published criteria developed by our group. These criteria allow differentiation of acute and chronic inflammatory changes.
  
  
  RESULTS
  Radiography demonstrated sacroiliitis in 18 patients: 4 of 53 in group 1 (7.5%), 14 of 45 in group 2 (31%), but none in groups 3, 4 and 5. In contrast, MR imaging demonstrated acute and/or chronic sacroiliitis in 44 patients: 18 of 53 in group 1 (34%), 21 of 45 in group 2 (46.7%) and 5 of 39 in group 3 (12.8%), but none in groups 4 and 5. The percentage of sacroiliitis detected by MR imaging was significantly higher than that detected by radiography (P<0.001).
  
  
  CONCLUSIONS
  Contrast-enhanced MR imaging is a useful method for detecting sacroiliitis in children. Advantages of contrast-enhanced MR imaging compared with conventional radiography are a higher sensitivity due to the ability to document early and acute changes and the absence of radiation exposure.
authors.affiliation: Department of Radiology, Charité Campus Mitte, Humboldt-Universität zu Berlin, Germany.
authors.forename: M
authors.initials: M
authors.lastname: Bollow
authors.forename: J
authors.initials: J
authors.lastname: Braun
authors.forename: T
authors.initials: T
authors.lastname: Biedermann
authors.forename: S
authors.initials: S
authors.lastname: Mutze
authors.forename: S
authors.initials: S
authors.lastname: Paris
authors.forename: C
authors.initials: C
authors.lastname: Schauer-Petrowskaja
authors.forename: K
authors.initials: K
authors.lastname: Minden
authors.forename: S A
authors.initials: SA
authors.lastname: Schmitz
authors.forename: M
authors.initials: M
authors.lastname: Schöntube
authors.forename: B
authors.initials: B
authors.lastname: Hamm
mesh_terms: D000293:Adolescent; D001168:Arthritis / Q000175:diagnosis*; D015535:Arthritis, Psoriatic / Q000175:diagnosis; D016918:Arthritis, Reactive / Q000175:diagnosis; D002648:Child; D003287:Contrast Media; D005260:Female; D019786:Gadolinium DTPA; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000295:instrumentation / Q000379:methods* / Q000706:statistics & numerical data; D008297:Male; D011446:Prospective Studies; D011859:Radiography; D012446:Sacroiliac Joint / Q000000981:diagnostic imaging / Q000473:pathology*; D012680:Sensitivity and Specificity; D013167:Spondylitis, Ankylosing / Q000175:diagnosis; D018709:Statistics, Nonparametric
chemical_list: D003287:Contrast Media; D019786:Gadolinium DTPA