[Determination of the best diagnostic criteria of sacroiliitis with MRI].
OBJECTIVE
To determine which signs are the most accurate in the diagnosis of sacroiliitis with MRI.


METHODS
40 consecutive patients with inflammatory low back pain underwent MRI at 1.5 T with FSE T2 and SE T1 weighted-images before and after Gadolinium-DOTA injection. 22 patients were suffering from spondylarthropathy while the other 18 patients constituted the control group. Each examination was interpreted by two independent observers who analysed 11 different signs.


RESULTS
Intra and inter observer reproducibility were high (respectively 76% and 70%). Inter observer reproducibility was excellent for bone marrow edema (89%) but low for bone productions (38%). Three lesions displayed a high positive predictive value: ligamentous contrast enhancement (86%), bone marrow edema (80%) and bone erosions (70%). Intra articular enhancement of the sacro-iliac joint was a less sensitive sign than bone marrow edema.


CONCLUSIONS
This study confirms the excellent positive predictive value of MRI for an early diagnosis of active sacroiliitis. Bone marrow edema seems to be a more pertinent sign than intra articular enhancement.
Bigot
J
J
Service d'Imagerie Guilloz (Pr J Roland), Hôpital Central, CHU Nancy, 29, avenue du Maréchal de Lattre de Tassigny, 54035 Nancy Cedex.
Loeuille
D
D
Chary-Valckenaere
I
I
Pourel
J
J
Cao
M M
MM
Blum
A
A
D000293:Adolescent; D000328:Adult; D000368:Aged; D001855:Bone Marrow Diseases / Q000209:etiology / Q000473:pathology; D016022:Case-Control Studies; D004487:Edema / Q000209:etiology / Q000473:pathology; D005260:Female; D006571:Heterocyclic Compounds; D006801:Humans; D016013:Likelihood Functions; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D015588:Observer Variation; D009942:Organometallic Compounds; D015203:Reproducibility of Results; D012446:Sacroiliac Joint; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D013166:Spondylitis / Q000145:classification / Q000209:etiology / Q000473:pathology*
D006571:Heterocyclic Compounds; D009942:Organometallic Compounds; C094044:gadolinium Cy(2)DOTA