MRI assessment of bone marrow oedema in the sacroiliac joints of patients with spondyloarthritis: is the SPAIR T2w technique comparable to STIR?
OBJECTIVE
To compare short tau inversion-recovery (STIR) with another fat saturation method in the assessment of sacroiliac joint inflammation.


METHODS
This prospective cross-sectional study comprised 76 spondyloarthritis (SpA) patients who underwent magnetic resonance imaging of the sacroiliac joints in a 1.5-T scanner, using STIR, spectral attenuated inversion recovery (SPAIR) T2w and spectral presaturation with inversion recovery (SPIR) T1w post-contrast sequences. Two independent readers (R1 and R2) assessed the images using the Spondyloarthritis Research Consortium of Canada (SPARCC) score. We assessed agreement of the SPARCC scores for SPAIR T2w and STIR with that for T1 SPIR post-contrast (reference standard) using the St. Laurent coefficient. We evaluated each sequence using the concordance correlation coefficient (CCC).


RESULTS
We observed a strong agreement between STIR and SPAIR T2w sequences. Lin's CCC was 0.94 for R1 and 0.84 for R2 for STIR and 0.94 for R1 and 0.84 for R2 for SPAIR. The interobserver evaluation revealed a good CCC of 0.79 for SPAIR and 0.78 for STIR.


CONCLUSIONS
STIR technique and SPAIR T2w sequence showed high agreement in the evaluation of sacroiliac joint subchondral bone marrow oedema in patients with SpA. SPAIR T2w may be an alternative to the STIR sequence for this purpose.


CONCLUSIONS
• There are no studies evaluating which fat saturation technique should be used. • SPAIR T2w may be an alternative to STIR for sacroiliac joint evaluation. • The study will lead to changes in guidelines for spondyloarthritis.
Division of Radiology, Department of Internal Medicine, Ribeirao Preto Medical School, University of Sao Paulo, Avenida Bandeirantes, 3900 - Monte Alegre, Zip Code: 14048-900, Ribeirão Preto, SP, Brazil. fdalto@gmail.com.
Vitor Faeda
VF
Dalto
Division of Clinical Imunology, Department of Internal Medicine, Ribeirao Preto Medical School, University of Sao Paulo, Avenida Bandeirantes, 3900 - Monte Alegre, Zip Code: 14048-900, Ribeirão Preto, SP, Brazil.
Rodrigo Luppino
RL
Assad
Service de Radiologie, Hôpital Saint-Antoine, Université Paris VI, Paris, France.|Department of Radiology, Quantitative Imaging Center, Boston University School of Medicine, Boston, MA, USA.|Departamento de Radiologia, Hospital do Coração (HCor) e Teleimagem, São Paulo, SP, Brazil.
Michel Daoud
MD
Crema
Department of Internal Medicine, Ribeirao Preto Medical School, University of Sao Paulo, Avenida Bandeirantes, 3900 - Monte Alegre, Zip Code: 14048-900, Ribeirão Preto, SP, Brazil.
Paulo
P
Louzada-Junior
Division of Radiology, Department of Internal Medicine, Ribeirao Preto Medical School, University of Sao Paulo, Avenida Bandeirantes, 3900 - Monte Alegre, Zip Code: 14048-900, Ribeirão Preto, SP, Brazil.
Marcello Henrique
MH
Nogueira-Barbosa
D000328:Adult; D001855:Bone Marrow Diseases / Q000000981:diagnostic imaging* / Q000473:pathology; D003430:Cross-Sectional Studies; D004487:Edema / Q000000981:diagnostic imaging* / Q000473:pathology; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012446:Sacroiliac Joint / Q000000981:diagnostic imaging* / Q000473:pathology; D058566:Sacroiliitis / Q000000981:diagnostic imaging / Q000473:pathology; D025241:Spondylarthritis / Q000000981:diagnostic imaging* / Q000473:pathology; D055815:Young Adult
Magnetic resonance imaging; Sacroiliitis; Spondylarthritis; Spondylitis; ankylosing