The application of T2W SPIR-FLAIR in the diagnosis of hip synovitis in patients with spondyloarthritis.
OBJECTIVE
To investigate the feasibility and accuracy of T2weighted spectral pre-saturation inversion recovery combined with fluid-attenuated inversion recovery (T2W SPIR-FLAIR) in the diagnosis of hip synovitis in patients with spondyloarthritis (SpA).


METHODS
10 volunteers underwent a T2W SPIR and 4 T2W SPIR-FLAIR sequence scans with different inversion times (TIs) to determine the optimum TI that could effectively suppress the intra-articular fluid signals. Hip MRI including T2W SPIR-FLAIR and enhanced T1weighted (T1W) SPIR sequences was performed in 45 patients with SpA and totally 90 hips were evaluated. McNemar's test and Kappa test were used to compare the diagnostic results of synovitis between T2W SPIR-FLAIR and enhanced T1W SPIR.


RESULTS
A TI of 2100 ms was selected as the optimum TI. 32 hips from 17 patients exhibited high signal intensity within the articular cavity on both T2W SPIR-FLAIR and enhanced T1W SPIR sequences, while only 3 hips showed high signals within the articular cavity on T2W SPIR-FLAIR. The remaining 55 hips did not show high signals within the articular cavity on both sequences. The T2W SPIR-FLAIR and enhanced T1W SPIR sequences had similar values in the diagnosis of hip synovitis (p = 0.25) and a high degree of diagnostic consistency (Kappa = 0.929).


CONCLUSIONS
T2W SPIR-FLAIR can effectively suppress the intra-articular fluid signals, while retaining the signals of thickened synovial membranes and can be used for the diagnosis of hip synovitis in patients with SpA. Advances in knowledge: The enhanced T1W SPIR is a classic sequence for synovitis diagnosis, but it requires the injection of contrast agents. The T2W SPIR-FLAIR and enhanced T1W SPIR sequences had similar values in the diagnosis of hip synovitis (p = 0.25) and a high degree of diagnostic consistency (Kappa = 0.929).
1 Department of Radiology, China-Japan Friendship Hospital, Beijing, China.
Zhen-Guo
ZG
Huang
1 Department of Radiology, China-Japan Friendship Hospital, Beijing, China.
Xiao-Liang
XL
Chen
2 Philips Healthcare, World Profit Center, Beijing, China.
Kai-Ning
KN
Shi
1 Department of Radiology, China-Japan Friendship Hospital, Beijing, China.
Ran
R
Yan
1 Department of Radiology, China-Japan Friendship Hospital, Beijing, China.
He
H
Chen
1 Department of Radiology, China-Japan Friendship Hospital, Beijing, China.
Min-Xing
MX
Yang
1 Department of Radiology, China-Japan Friendship Hospital, Beijing, China.
Bao-Xiang
BX
Gao
3 Philips Healthcare, Hong Kong, China.
Queenie
Q
Chan
4 Department of Rheumatology, China-Japan Friendship Hospital, Beijing, China.
Guo-Chun
GC
Wang
D000328:Adult; D005240:Feasibility Studies; D005260:Female; D006621:Hip Joint / Q000000981:diagnostic imaging*; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D015203:Reproducibility of Results; D025241:Spondylarthritis / Q000150:complications*; D013585:Synovitis / Q000150:complications* / Q000000981:diagnostic imaging*; D055815:Young Adult
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