Aktif sakroiliit tanısında STIR ve postkontrast MRG bulgularının retrospektif karşılaştırılması
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Tarih
2018
Yazarlar
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Cilt Başlığı
Yayıncı
Ege Üniversitesi, Tıp Fakültesi
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
AMAÇ: Aktif sakroiliit bulgularını saptamada STIR sekansının başarısının değerlendirilmesi ve altın standart kontrastlı yağ baskılı T1 sekansı ile karşılaştırılması
GEREÇ VE YÖNTEM: Çalışmamıza 202 aktif sakroiliit tanılı olgu dahil edildi. Olgularda aktif sakroiliit bulguları(kemik iliği ödemi, sinovit, kapsulit ve entezit) önce STIR sekansında değerlendirildi daha sonra kontrast sonrası yağ baskılamalı T1 görüntülerle karşılaştırılarak STIR sekansının başarısı değerlendirildi.
BULGULAR: Olguların hepsinde STIR sekansında kemik iliği ödemi(KİÖ) saptanan alanlarda kontrastlı görüntülerde parlaklaşma izlendi. Yedi (%3.4) hastada T1 kontrastlı görüntülerde ek odak saptandı. Sinovit toplam 20(%9.9) olguda saptandı, 1(%0.5) olguda STIR sekansında görüldü. Kapsulit total 14 (%6.9) olguda saptandı, 11(%5.4) olguda STIR sekansta görüldü. Entezit 1 (%0.5) olguda izlendi ve sadece kontrastlı T1 görüntülerde değerlendirildi. Kemik iliği ödemi, kapsulit için istatiksel olarak anlamlı fark bulunurken (p <0.05), sinovit ve entezit için anlamlı fark bulunmadı.
SONUÇ: Aktif sakroiliitin pozitif MRG bulgusu olan kemik iliği ödemi saptamada STIR sekansının başarısı yüksek olup altın standart kontrastlı T1 görüntülerle %100 uyumluluk izlenmektedir. Kapsulit, entezit ve sinovit bulguları kemik iliği bulgusuna eşlikçi bulgu olarak izlenmekte ve tek başına tanısal değer oluşturmamaktadır.
Purpose: The purpose of the study was to determine the diagnostic value of STIR (short tau inversion recovery ) sequence and to compare with gold standard fat saturated contrast enhanced T1 –weighted spin –echo sequences in the detection of active sacroiliitis. Materials and methods: The study included 202 patients with active sacroiliitis. The presence of bone marrow edema, capsulitis, synovitis and enthesitis were analyzed separately before contrast enhancement with STIR and after contrast enhancement T1 fat saturated MRI sequence. Results: STIR and T1/gadolinium sequences had 100% agreement for depiction of bone marrow edema. In 7(3.4%) patients additional bone marrow edema was depicted on T1 gadolinium sequence. Synovitis was seen in 20/202 (9.9%) patients, in 1 (0.5%) patient was depicted on STIR sequence. Capsulitis was seen in 14/202(6.9%) patients, in 11(5.4%) patients depicted on STIR sequence. Enthesitis was seen in 1/202 (0.5%) patient and depicted only on T1 contrast fat saturated MRI sequence. There were statistically significant for depicting bone marrow edema and capsulitis(p<0.05), but not for synovitis and enthesitis. Conclusion: STIR sequence alone is sufficient to identify bone marrow edema which is the pozitive MRI sign of active sacroiliitis and there was 100% agreement between STIR and gold standart contrast enhancement T1 MRI sequence. There is not diagnostic confidence of capsulitis, synovitis and enthesitis alone without bone marrow edema.
Purpose: The purpose of the study was to determine the diagnostic value of STIR (short tau inversion recovery ) sequence and to compare with gold standard fat saturated contrast enhanced T1 –weighted spin –echo sequences in the detection of active sacroiliitis. Materials and methods: The study included 202 patients with active sacroiliitis. The presence of bone marrow edema, capsulitis, synovitis and enthesitis were analyzed separately before contrast enhancement with STIR and after contrast enhancement T1 fat saturated MRI sequence. Results: STIR and T1/gadolinium sequences had 100% agreement for depiction of bone marrow edema. In 7(3.4%) patients additional bone marrow edema was depicted on T1 gadolinium sequence. Synovitis was seen in 20/202 (9.9%) patients, in 1 (0.5%) patient was depicted on STIR sequence. Capsulitis was seen in 14/202(6.9%) patients, in 11(5.4%) patients depicted on STIR sequence. Enthesitis was seen in 1/202 (0.5%) patient and depicted only on T1 contrast fat saturated MRI sequence. There were statistically significant for depicting bone marrow edema and capsulitis(p<0.05), but not for synovitis and enthesitis. Conclusion: STIR sequence alone is sufficient to identify bone marrow edema which is the pozitive MRI sign of active sacroiliitis and there was 100% agreement between STIR and gold standart contrast enhancement T1 MRI sequence. There is not diagnostic confidence of capsulitis, synovitis and enthesitis alone without bone marrow edema.
Açıklama
Anahtar Kelimeler
Sakroiliit, MRG, STIR, Kontrastlı MRG, Sacroiliitis, MRI, STIR, Contrast Enhanced MRI
