16th Annual Congress of the European Society of Musculoskeletal Radiology (ESSR), Genoa, Italy - June 11-13, 2009.

摘要

Erosions, but not bone marrow edema or contrast medium enhancement, are specific features in MRI of ankylosing spondylitis patients M C Wick, R J Weiss, W Jaschke, A S Klauser; Austria, Sweden (marius.wick@i-med.ac.at) Purpose / Introduction: To determine the most relevant radiological features in magnetic resonance imaging (MRI) of sacroiliac joints in patients with ankylosing spondylitis (AS) compared to those with sacroiliac involvement of other rheumatic diseases or degenerative sacroiliac pain. Materials and Methods: We retrospectively analyzed laboratory values, clinical data, and contrast medium enhanced MRIs of the sacroiliac joints of patients (46 male/133 female) admitted to the Radiology Department between 2002-2006 for evaluation of AS-suspicious sacroiliac pain. Standardized MRIs were semi-quantitatively assessed utilizing the SPARCC method for formal statistical comparisons. Results: Of all 179 patients, 27 (15percent) were diagnosed with definite AS a mean (SD) of 21.6 (40.5) days after MRI. The remainder had sacroiliac involvement in other rheumatic diseases, HLA-B27 negative spondylarthropathy, or unspe-cific degenerative changes. While joint space irregularities, bone marrow edema, sub-cortical cysts, and contrast medium enhancement were found in MRIs of all patients, these features were inconsistent, and only erosions were statistically significantly (p<0.02) in patients who were finally diagnosed with AS. The presence of erosions and SPARCC erosion score in AS correlated to a statistically significant degree (p<0.02) with levels of inflammation. Discussion / Conclusion: Erosions alone, not bone marrow edema or contrast medium enhancement, are specific measurable imaging findings in sacroiliac MRI of AS patients.