title: Vertebral body corner oedema vs gadolinium enhancement as biomarkers of active spinal inflammation in ankylosing spondylitis.
abstract: OBJECTIVE
  To investigate the relative performance of T(2) weighted short tau inversion-recovery (STIR) and fat-suppressed T(1) weighted gadolinium contrast-enhanced sequences in depicting active inflammatory lesions in ankylosing spondylitis (AS).
  
  
  METHODS
  Whole-spine MRI was performed on 32 patients with AS, who participated in a clinical trial of infliximab treatment, by STIR and contrast-enhanced sequences at baseline and after 30 weeks. The AS spine MRI-activity (ASspiMRI-a) scoring method was used. The images from these two imaging techniques were evaluated separately by two independent readers.
  
  
  RESULTS
  For the pre-treatment lesion status, the intraclass correlation coefficients comparing STIR readings and contrast-enhanced readings were 0.69±0.23 for Reader 1 and 0.65±0.21 for Reader 2. At baseline, the mean ASspiMRI-a score was 15.4% and 17.7% higher for contrast-enhanced images than for STIR images for Reader 1 and Reader 2, respectively. After infliximab treatment, Reader 1 rated an ASspiMRI-a score reduction of 50.8±33.6% and 25.3±35.3% for STIR images and contrast-enhanced images, respectively, whereas Reader 2 rated an ASspiMRI-a score reduction of 42.4±50.4% and 32.9±35.6% for STIR images and contrast-enhanced images, respectively.
  
  
  CONCLUSIONS
  While both contrast-enhanced and STIR sequences showed sensitivity to change over a short period of time after infliximab treatment, these two sequences may reflect different disease mechanisms.
authors.affiliation: Department of Imaging and Interventional Radiology, The Chinese University of Hong Kong, Prince of Wales Hospital,Shatin, Hong Kong, China. yixiang_wang@cuhk.edu.hk
authors.forename: Y-X J
authors.initials: YX
authors.lastname: Wang
authors.forename: J F
authors.initials: JF
authors.lastname: Griffith
authors.forename: M
authors.initials: M
authors.lastname: Deng
authors.forename: T K
authors.initials: TK
authors.lastname: Li
authors.forename: L-S
authors.initials: LS
authors.lastname: Tam
authors.forename: V W Y
authors.initials: VW
authors.lastname: Lee
authors.forename: K K C
authors.initials: KK
authors.lastname: Lee
authors.forename: E K
authors.initials: EK
authors.lastname: Li
mesh_terms: D000328:Adult; D015415:Biomarkers; D003287:Contrast Media; D004487:Edema / Q000175:diagnosis* / Q000209:etiology; D005260:Female; D006801:Humans; D007089:Image Enhancement / Q000379:methods*; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008536:Meglumine; D008875:Middle Aged; D009187:Myelitis; D009942:Organometallic Compounds; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D013131:Spine / Q000473:pathology*; D013167:Spondylitis, Ankylosing / Q000150:complications / Q000473:pathology*; D051598:Whole Body Imaging / Q000379:methods*
chemical_list: D015415:Biomarkers; D003287:Contrast Media; D009942:Organometallic Compounds; D008536:Meglumine; C072417:gadoterate meglumine