천장 관절의 골 미란을 발견하는데 있어서 초단파 에코 시간 자기 공명 영상의 유용성

Abstract

Objective : To evaluate whether the combination of ultrashort TE (UTE) sequences and conventional magnetic resonance imaging (MRI) helps to increase diagnostic accuracy for patient with spondyloarthropathy(SpA) compared with those achieved by using each MRI technique alone.

Materials and Methods : The study included two groups those are 28 sacroiliac joints' (SIJ) MR scans from 14 patients with SpA (SpA group) and 18 SIJs' MR scans from 9 patients without SpA (control group). SpA was clinically diagnosed by rheumatologist's opinion. Four sets of MRI sequences (T1, CE T1FS, T2FS, and UTE) were assessed independently by two musculoskeletal radiologists for evaluating bone marrow edema, enhancement, and bony erosion. The frequency of detected lesions in two group was analyzed as the median and mean sum-score. ROC curves were calculated depending on each lesions and combination sets of lesions.

Results : The median value of MRI lesion sum-score in SpA group was relatively higher for the UTE (reader1, 5.0; reader2, 7.0) than conventional MRI (reader1, 1.5~4.5; reader2, 2.0). Combination set of UTE and conventional MRI had a higher AUC than UTE-only or conventional MRI-only sets (reader1, 0.913 vs 0.857 vs 0.867; reader2, 0.921 vs 0.893 vs 0.790, respectively). Regarding the detection of erosion, readers showed high diagnostic confidence on UTE compared with T1WI (reader1, 2.74 vs 1.74; reader2, 2.52 vs 1.83, respectively).

Conclusion : Additional application of UTE to conventional MRI shows better diagnostic accuracy and confidence in the diagnosis of SpA compared with conventional sequence only.

KEY WORDS : Ultrashort echo time, Magnetic resonance imaging, Spondyloarthropathy, Sacroiliac joint