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Permanent URL to this publication: http://dx.doi.org/10.5167/uzh-34330

Weber, U; Lambert, R G; Ostergaard, M; Hodler, J; Pedersen, S J; Maksymowych, W P (2010). The diagnostic utility of MRI in spondyloarthritis: An international multicentre evaluation of 187 subjects (The MORPHO study). Arthritis and Rheumatism, 62(10):3048-3058.

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Abstract

OBJECTIVE:: To systematically assess the diagnostic utility of MRI to differentiate spondyloarthritis (SpA) patients from patients with non-specific back pain (NSBP) and healthy volunteers using a standardized evaluation of MR images of the sacroiliac joints (SIJ). METHODS:: Five readers blinded to patient and diagnosis independently assessed MRI scans (T1-weighted and STIR sequences) of the SIJ from 187 subjects: 75 patients with AS (symptom duration </=10 years); 27 patients with pre-radiographic inflammatory back pain (IBP) (mean symptom duration 29 months); 26 NSBP and 59 healthy controls </=45 years. Bone marrow edema (BME), fat infiltration, erosion, and ankylosis were recorded according to standardized definitions using an online data entry system. We calculated sensitivity, specificity, positive (LR+) and negative (LR-) likelihood ratios for the diagnosis of SpA based on global assessment of the MRI scans. RESULTS:: Diagnostic utility was high for all 5 readers for both AS (sensitivity 0.90, specificity 0.97, LR+ 44.6) and pre-radiographic IBP patients (sensitivity 0.51, specificity 0.97, LR+ 26.0). Diagnostic utility based solely on detection of BME enhanced sensitivity (67%) for IBP patients but reduced specificity (88%); detection of erosions in addition to BME further enhanced sensitivity (81%) without changing specificity. A single MRI lesion of the SIJ was observed in up to 27% of control individuals. CONCLUSION:: This systematic and standardized evaluation of SIJ in SpA patients showed that MRI has much greater diagnostic utility than documented previously. We present for the first time a data driven definition of a positive MRI for SpA.

Item Type:Journal Article, refereed, original work
Communities & Collections:04 Faculty of Medicine > University Hospital Zurich > Clinic for Diagnostic and Interventional Radiology
04 Faculty of Medicine > Balgrist University Hospital, Swiss Spinal Cord Injury Center
DDC:610 Medicine & health
Language:English
Date:October 2010
Deposited On:10 Jun 2010 13:01
Last Modified:27 Nov 2013 23:00
Publisher:Wiley-Blackwell
ISSN:0004-3591
Publisher DOI:10.1002/art.27571
PubMed ID:20496416
Citations:Web of Science®. Times Cited: 58
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Scopus®. Citation Count: 60

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