Whole-body MRI

全身 MRI
  • 文章类型: Journal Article
    神经纤维瘤病(NF)I型是由神经纤维蛋白肿瘤抑制基因突变引起的神经外胚层和中胚层发育不良。NF1的表型特征各不相同,患者发展为良性外周神经鞘瘤和恶性肿瘤,如恶性外周神经鞘瘤,恶性黑色素瘤,和星形细胞瘤.多参数全身MR成像(WBMRI)在疾病监测中起着至关重要的作用。多参数MRI,通常用于前列腺成像,是包含多个序列的技术的通用术语,即解剖,扩散,以及基于Dixon的造影前后成像。本文讨论了多参数WBMRI的价值,并说明了NF1在单个成像环境中的全身病变谱。病变的例子包括皮肤(肿瘤和腋窝雀斑),软组织(良性和恶性外周神经鞘瘤,内脏丛状,和弥漫性病变),骨骼和关节(营养神经损伤,非骨化性纤维瘤,关节内神经纤维瘤,等。),脊柱(锐角脊柱侧弯,硬脑膜扩张,椎管内肿瘤,等。),和大脑/头骨(视神经胶质瘤,脉络丛黄色肉芽肿,蝶骨翼发育不良,大脑错构瘤,等。).读完这篇文章后,读者将了解NF1遇到的各种病变及其WBMRI表现。及时识别此类病变可以帮助准确诊断和适当的患者管理。
    Neurofibromatosis (NF) type I is a neuroectodermal and mesodermal dysplasia caused by a mutation of the neurofibromin tumor suppressor gene. Phenotypic features of NF1 vary, and patients develop benign peripheral nerve sheath tumors and malignant neoplasms, such as malignant peripheral nerve sheath tumor, malignant melanoma, and astrocytoma. Multiparametric whole-body MR imaging (WBMRI) plays a critical role in disease surveillance. Multiparametric MRI, typically used in prostate imaging, is a general term for a technique that includes multiple sequences, i.e. anatomic, diffusion, and Dixon-based pre- and post-contrast imaging. This article discusses the value of multiparametric WBMRI and illustrates the spectrum of whole-body lesions of NF1 in a single imaging setting. Examples of lesions include those in the skin (tumors and axillary freckling), soft tissues (benign and malignant peripheral nerve sheath tumors, visceral plexiform, and diffuse lesions), bone and joints (nutrient nerve lesions, non-ossifying fibromas, intra-articular neurofibroma, etc.), spine (acute-angled scoliosis, dural ectasia, intraspinal tumors, etc.), and brain/skull (optic nerve glioma, choroid plexus xanthogranuloma, sphenoid wing dysplasia, cerebral hamartomas, etc.). After reading this article, the reader will gain knowledge of the variety of lesions encountered with NF1 and their WBMRI appearances. Timely identification of such lesions can aid in accurate diagnosis and appropriate patient management.
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  • 文章类型: Journal Article
    前列腺癌是全球最普遍的肿瘤之一。虽然早期检测降低了转移的可能性,管理晚期病例对诊断和治疗提出了挑战。当前的国际指南支持同时使用99Tc骨闪烁显像和对比增强的胸部和腹部CT来进行转移性疾病的分期和反应评估。然而,新出现的证据强调了包括PSMA-PET/CT和全身MRI(WB-MRI)在内的下一代成像技术的优越性。这篇综述探讨了有关WB-MRI在转移性前列腺癌中的作用的相关科学文献。这种多参数成像技术,将标准MRI序列的高解剖分辨率与弥散加权成像(DWI)和骨髓相对脂肪分数(rFF%)等功能序列相结合,已被证明在全面的患者评估中有效。评估局部疾病,大部分节点参与,骨转移及其并发症,并检测前列腺癌内脏转移的增加。它确实具有避免注射造影剂/放射性核素给药的优点,让病人免于接触电离辐射,并且缺乏用核医学技术描述的FLARE的混淆者。关于WB-MRI诊断能力的最新文献,尽管与PSMA-PET/CT相比仍然有限,强烈支持将其广泛纳入标准临床实践,最新的核医学技术.
    Prostate cancer ranks among the most prevalent tumours globally. While early detection reduces the likelihood of metastasis, managing advanced cases poses challenges in diagnosis and treatment. Current international guidelines support the concurrent use of 99Tc-Bone Scintigraphy and Contrast-Enhanced Chest and Abdomen CT for the staging of metastatic disease and response assessment. However, emerging evidence underscores the superiority of next-generation imaging techniques including PSMA-PET/CT and whole-body MRI (WB-MRI). This review explores the relevant scientific literature on the role of WB-MRI in metastatic prostate cancer. This multiparametric imaging technique, combining the high anatomical resolution of standard MRI sequences with functional sequences such as diffusion-weighted imaging (DWI) and bone marrow relative fat fraction (rFF%) has proved effective in comprehensive patient assessment, evaluating local disease, most of the nodal involvement, bone metastases and their complications, and detecting the increasing visceral metastases in prostate cancer. It does have the advantage of avoiding the injection of contrast medium/radionuclide administration, spares the patient the exposure to ionizing radiation, and lacks the confounder of FLARE described with nuclear medicine techniques. Up-to-date literature regarding the diagnostic capabilities of WB-MRI, though still limited compared to PSMA-PET/CT, strongly supports its widespread incorporation into standard clinical practice, alongside the latest nuclear medicine techniques.
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  • 文章类型: Journal Article
    这篇综述集中在风湿性疾病患者中最常见的全身MRI应用,该工具对放射科医生和临床医生都有帮助。它报告了1.5和3.0T扫描仪的技术方面。本文列出了在评估特定病理时帮助放射科医生的主要发现,在诊断阶段和随访期间。
    This review focuses on the most frequent whole-body MRI applications in patients with rheumatological pathologies, for which this tool can be helpful to both radiologists and clinicians. It reports technical aspects of the acquisition of both 1.5 and 3.0 T scanners. The article lists the main findings that help radiologists during the evaluation of a specific pathology, both in the diagnostic phase and during follow-up.
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  • 文章类型: Case Reports
    我们在此介绍一例33岁女性,无异时性双侧乳腺癌和骨肉瘤家族史,诊断为Li-Fraumeni综合征(LFS),这是一种罕见的常染色体显性遗传性癌症综合征,与种系TP53变异有关。她在16岁时被诊断为左侧股骨远端骨肉瘤,在29岁和33岁时被诊断为异型双侧乳腺癌。当第三个癌症被诊断出来时,我们怀疑有遗传性肿瘤综合征,并将患者转诊至我们的遗传门诊.没有LFS的核心癌症家族史,但既然病人符合Chompret的标准,种系TP53基因检测是根据患者意愿进行的。一种致病变体,TP53:c.216dupC(p。Val73ArgfsX76)在该基因的外显子4中发现。这种情况是有说服力的,因为在诊断LFS之前对第一例乳腺癌进行了放射治疗;如果由于无法修复DNA损伤,LFS中有其他选择,则应避免辐射。作为一个教训,肿瘤学家重申了从关键词“多重,\"\"年轻,\"\"家族性,\"和\"罕见,“并咨询遗传部门。此外,建议在LFS中使用全身磁共振成像进行监测.然而,该系统尚未在全国范围内提供,但我们刚在医院安顿下来.
    We herein present the case of a 33-year-old woman with no family history of metachronous bilateral breast cancer and osteosarcoma, diagnosed with Li-Fraumeni syndrome (LFS), which is a rare autosomal dominant hereditary cancer syndrome associated with a germline TP53 variant. She was diagnosed with left distal femoral osteosarcoma at the age of 16, and metachronous bilateral breast cancer at the ages of 29 and 33. When the third cancer was diagnosed, a hereditary tumor syndrome was suspected and the patient was referred to our genetic outpatient clinic. There was no family history of the \'core\' cancers for LFS, but since the patient met Chompret\'s criteria, germline TP53 genetic testing was performed with the patient\'s will. A pathogenic variant, TP53:c.216dupC (p.Val73ArgfsX76) was found in exon 4 of the gene. This case is didactic because radiotherapy was performed on the first breast cancer before the diagnosis of LFS was made; radiation should be avoided if there are other options in LFS because of the inability to repair DNA damage. As a lesson learned, oncologists reaffirmed the importance of being aware of hereditary tumors from the keywords \"multiple,\" \"young,\" \"familial,\" and \"rare,\" and consulting the genetic department. In addition, surveillance using whole-body magnetic resonance imaging is recommended in LFS. However, this system is not yet provided nationwide, but we have newly settled it in our hospital.
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  • 文章类型: Journal Article
    目的:全身MRI(WB-MRI)中的图像质量可能因射频(RF)线圈元件故障或线圈阵列错位而降低。基于幻影的质量控制(QC)用于识别损坏的RF线圈元件,但是这些采集的频率受到扫描仪和工作人员可用性的限制。这项工作旨在开发扫描特定的QC采集和处理管道,以检测损坏的RF线圈元件,这是足够快被添加到临床WB-MRI协议。这样做的目的是通过减少使用次优设备进行的患者检查的数量来提高WB-MRI的质量。 方法:开发了一种快速采集(每个成像站额外采集时间14秒),通过从每个单独的线圈元件采集图像并使用整体线圈来识别损坏的RF线圈元件。该采集被添加到一个中心的临床WB-MRI方案中,为期一年(892次检查),以评估该扫描特异性QC的效果。为了证明在多中心成像试验中的适用性,该技术也在三家制造商的扫描仪上实施。 主要结果:在研究过程中,射频线圈元件被标记为可能损坏的情况有5次,在其中四个案例中确认了故障。该方法具有80%的精度和100%的召回率,用于检测故障的RF线圈元件。线圈阵列定位测量在扫描仪上是一致的,并已用于定义信号的预期变化。
意义:此处演示的技术可以识别故障的RF线圈元件和定位误差,并且是临床WB-MRI协议的实用补充。这种方法在三个制造商的系统上完全实施,在第三个制造商上部分实施。它有可能减少使用次优硬件进行的临床检查的数量,并提高多中心研究的图像质量。
    Objective.Image quality in whole-body MRI (WB-MRI) may be degraded by faulty radiofrequency (RF) coil elements or mispositioning of the coil arrays. Phantom-based quality control (QC) is used to identify broken RF coil elements but the frequency of these acquisitions is limited by scanner and staff availability. This work aimed to develop a scan-specific QC acquisition and processing pipeline to detect broken RF coil elements, which is sufficiently rapid to be added to the clinical WB-MRI protocol. The purpose of this is to improve the quality of WB-MRI by reducing the number of patient examinations conducted with suboptimal equipment.Approach.A rapid acquisition (14 s additional acquisition time per imaging station) was developed that identifies broken RF coil elements by acquiring images from each individual coil element and using the integral body coil. This acquisition was added to one centre\'s clinical WB-MRI protocol for one year (892 examinations) to evaluate the effect of this scan-specific QC. To demonstrate applicability in multi-centre imaging trials, the technique was also implemented on scanners from three manufacturers.Main results. Over the course of the study RF coil elements were flagged as potentially broken on five occasions, with the faults confirmed in four of those cases. The method had a precision of 80% and a recall of 100% for detecting faulty RF coil elements. The coil array positioning measurements were consistent across scanners and have been used to define the expected variation in signal.Significance. The technique demonstrated here can identify faulty RF coil elements and positioning errors and is a practical addition to the clinical WB-MRI protocol. This approach was fully implemented on systems from two manufacturers and partially implemented on a third. It has potential to reduce the number of clinical examinations conducted with suboptimal hardware and improve image quality across multi-centre studies.
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  • 文章类型: Journal Article
    背景:身体组成和身体脂肪分布是心脏代谢疾病的重要预测因子。心脏代谢疾病的病因是异质性的,部分由组织特异性胰岛素敏感性的个体间差异驱动。
    目的:研究(1)身体成分与全身的关系,肝脏和肌肉胰岛素敏感性,(2)在高不饱和脂肪酸(HMUFA)或低脂等热量饮食12周后,身体成分和胰岛素敏感性的变化及其关系,高蛋白,高纤维(LFHP)饮食。
    方法:这项PERSON研究的子队列分析包括93名个体(53%的女性,BMI25-40kg/m2,40-75岁)参加了这项随机干预研究。在基线和12周后LFHP,或HMUFA饮食,我们进行了7点口服葡萄糖耐量试验来评估全身,肝脏,和肌肉胰岛素敏感性,和全身磁共振成像来确定身体成分和体内脂肪分布。这两种饮食都符合健康营养的指导原则。
    结果:在基线时,肝脏脂肪含量与更差的肝脏胰岛素敏感性相关(β[95CI];0.12[0.01;0.22])。只有在女人身上,大腿肌肉脂肪含量与肌肉胰岛素敏感性呈负相关(-0.27[-0.48;-0.05])。内脏脂肪组织(VAT)与全身呈负相关,肝脏,和肌肉胰岛素敏感性。两种饮食都降低了增值税,腹部皮下脂肪组织(aSAT),和肝脏脂肪,但不是全身和组织特异性胰岛素敏感性,饮食之间没有差异。腰围,然而,与HMUFA饮食相比,LFHP饮食后下降更多(-3.0vs.-0.5厘米,分别)。在LFHP而不是HMUFA饮食之后,身体成分的改善与全身和肝脏胰岛素敏感性的改善呈正相关.
    结论:肝脏和肌肉胰岛素敏感性与肝脏和肌肉脂肪积累明显相关。尽管LFHP和HMUFA饮食在体内脂肪方面都有所改善,VAT,aSAT,和肝脏脂肪,只有LFHP诱导的身体成分改善与胰岛素敏感性改善相关.
    背景:NCT03708419(clinicaltrials.gov)。
    BACKGROUND: Body composition and body fat distribution are important predictors of cardiometabolic diseases. The etiology of cardiometabolic diseases is heterogenous, and partly driven by inter-individual differences in tissue-specific insulin sensitivity.
    OBJECTIVE: To investigate (1) the associations between body composition and whole-body, liver and muscle insulin sensitivity, and (2) changes in body composition and insulin sensitivity and their relationship after a 12-week isocaloric diet high in mono-unsaturated fatty acids (HMUFA) or a low-fat, high-protein, high-fiber (LFHP) diet.
    METHODS: This subcohort analysis of the PERSON study includes 93 individuals (53% women, BMI 25-40 kg/m2, 40-75 years) who participated in this randomized intervention study. At baseline and after 12 weeks of following the LFHP, or HMUFA diet, we performed a 7-point oral glucose tolerance test to assess whole-body, liver, and muscle insulin sensitivity, and whole-body magnetic resonance imaging to determine body composition and body fat distribution. Both diets are within the guidelines of healthy nutrition.
    RESULTS: At baseline, liver fat content was associated with worse liver insulin sensitivity (β [95%CI]; 0.12 [0.01; 0.22]). Only in women, thigh muscle fat content was inversely related to muscle insulin sensitivity (-0.27 [-0.48; -0.05]). Visceral adipose tissue (VAT) was inversely associated with whole-body, liver, and muscle insulin sensitivity. Both diets decreased VAT, abdominal subcutaneous adipose tissue (aSAT), and liver fat, but not whole-body and tissue-specific insulin sensitivity with no differences between diets. Waist circumference, however, decreased more following the LFHP diet as compared to the HMUFA diet (-3.0 vs. -0.5 cm, respectively). After the LFHP but not HMUFA diet, improvements in body composition were positively associated with improvements in whole-body and liver insulin sensitivity.
    CONCLUSIONS: Liver and muscle insulin sensitivity are distinctly associated with liver and muscle fat accumulation. Although both LFHP and HMUFA diets improved in body fat, VAT, aSAT, and liver fat, only LFHP-induced improvements in body composition are associated with improved insulin sensitivity.
    BACKGROUND: NCT03708419 (clinicaltrials.gov).
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  • 文章类型: Journal Article
    目的:本系统综述评估了全身MRI(WB-MRI)作为携带种系TP53突变的个体的癌症筛查工具,已知恶性肿瘤风险显著升高的人群。主要目的是评估WB-MRI在该队列中检测癌症的诊断性能。
    方法:PubMed,MEDLINE,EMBASE和Cochrane中央控制试验登记处一直搜索到2023年8月18日。根据预定的纳入标准选择合格的研究。提取的数据包括有关研究特征的信息,患者人口统计学,和WB-MRI诊断性能。
    结果:本系统评价确定了8项符合条件的研究,包括506个TP53突变携带者。平均年龄为34.6±16.3(范围1-74)岁。总的来说,321/506(63.4%)患者为女性,185/506(36.6%)为男性。此外,267/506(52.8%)以前有肿瘤诊断。通过WB-MRI诊断出36种新癌症(36/506(7.1%))。在MRI上检测到的癌症的总合并比例为7%(95%置信区间5-10)。总的来说,发现了44个新的病灶,因为在一些患者中发现了多发性病变。
    结论:WB-MRI是TP53突变携带者的有效癌症筛查工具。虽然这些发现表明WB-MRI可能有助于在这个高危人群中早期发现癌症,为了优化其临床应用,有必要进行进一步的研究和国际标准化方案.
    OBJECTIVE: This systematic review evaluated whole-body MRI (WB-MRI) as a cancer screening tool for individuals carrying germline TP53 mutations, a population known to be at a significantly elevated risk of malignancy. The primary objective is to assess the diagnostic performance of WB-MRI in detecting cancer in this cohort.
    METHODS: PubMed, MEDLINE, EMBASE and the Cochrane Central Registry of Controlled Trials were searched until 18 August 2023. Eligible studies were selected based on predefined inclusion criteria. The data extracted included information on study characteristics, patient demographics, and the WB-MRI diagnostic performance.
    RESULTS: This systematic review identified eight eligible studies, comprising 506 TP53 mutation carriers. The mean age was 34.6 ± 16.3 (range 1-74) years. In total, 321/506 (63.4%) of the patients were female and 185/506 (36.6%) were male. In addition, 267/506 (52.8%) had a previous oncological diagnosis. Thirty-six new cancers were diagnosed with WB-MRI (36/506 (7.1%)). The overall pooled proportion of cancer detected on MRI was 7% (95% confidence interval 5-10). In total, 44 new lesions were picked up, as multiple lesions were found in some patients.
    CONCLUSIONS: WB-MRI is an effective cancer screening tool for TP53 mutation carriers. While these findings suggest the potential for WB-MRI to contribute to early cancer detection in this high-risk population, further research and the standardisation of protocols internationally are warranted to optimise its clinical utility.
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  • 文章类型: Journal Article
    全身磁共振成像(WB-MRI)巩固了其作为肿瘤诊断中关键工具的地位。它提供了无与伦比的软组织对比度分辨率和回避电离辐射的优势。本文就WB-MRI在肿瘤学中的多种应用作一综述。我们讨论了它在检测和诊断一系列癌症中的转化作用,强调多发性骨髓瘤和具有骨转移倾向的癌症。WB-MRI在单一扫描中涵盖整个身体的能力开创了癌症筛查的新范式,特别是对于患有遗传性癌症综合征或转移性疾病风险增加的个体。此外,它对临床景观的贡献,协助多灶性和全身性恶性肿瘤的整体管理,正在探索。文章强调了WB-MRI取得的技术进步,其无数的临床公用事业,以及整合到标准肿瘤护理中的挑战。实质上,这篇综述强调了WB-MRI的转化潜力,强调其作为塑造癌症诊断和治疗未来轨迹的基石模式的承诺。
    Whole-Body Magnetic Resonance Imaging (WB-MRI) has cemented its position as a pivotal tool in oncological diagnostics. It offers unparalleled soft tissue contrast resolution and the advantage of sidestepping ionizing radiation. This review explores the diverse applications of WB-MRI in oncology. We discuss its transformative role in detecting and diagnosing a spectrum of cancers, emphasizing conditions like multiple myeloma and cancers with a proclivity for bone metastases. WB-MRI\'s capability to encompass the entire body in a singular scan has ushered in novel paradigms in cancer screening, especially for individuals harboring hereditary cancer syndromes or at heightened risk for metastatic disease. Additionally, its contribution to the clinical landscape, aiding in the holistic management of multifocal and systemic malignancies, is explored. The article accentuates the technical strides achieved in WB-MRI, its myriad clinical utilities, and the challenges in integration into standard oncological care. In essence, this review underscores the transformative potential of WB-MRI, emphasizing its promise as a cornerstone modality in shaping the future trajectory of cancer diagnostics and treatment.
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  • 文章类型: Journal Article
    背景:乳腺癌是女性常见的恶性肿瘤,并且使用具有背景身体信号抑制(DWIBS)的扩散加权全身成像已经证明了诊断其转移和复发的有效性。然而,由于磁共振成像(MRI)的独特情况,DWIBS会给患者带来困扰。这项研究旨在调查乳腺癌女性中DWIBS引起的各种困扰因素,并评估在结合放松技术的环境中设计的新型MRI系统的有效性。
    方法:从2022年5月至9月,我们对乳腺癌女性中DWIBS相关困扰进行了问卷调查。问卷是针对在常规MRI系统(19名女性)和配备有放松技术装备功能的新系统(20名女性)上接受DWIBS的参与者进行的。包括投影图像,照明,和声音。参与者在面部量表(0-10)上对各种压力因素的程度进行了评分。使用Mann-WhitneyU检验比较了两个系统的得分。
    结果:在常规系统中,女性因MRI特定情况而经历痛苦,例如在密闭空间中的不动,噪音,感觉被困,以及对不动的担忧。这些结果并没有显示出乳腺癌女性接受DWIBS的具体趋势。对于几乎所有的遇险参数,与常规系统相比,新系统的痛苦评分明显较低(p>0.05)。
    结论:使用新的放松技术的舒适环境可以通过接近人类的感官来有效缓解患者的焦虑。
    结论:减少乳腺癌女性DWIBS引起的痛苦可以提供舒适的检查环境,在更长的治疗期间可能会帮助他们。
    BACKGROUND: Breast cancer is a common malignant tumor among women, and the effectiveness of diagnosing its metastasis and recurrence has been demonstrated using diffusion-weighted whole-body imaging with background body signal suppression (DWIBS). However, DWIBS causes distress to patients due to the unique circumstances of magnetic resonance imaging (MRI). This study aimed to investigate the various distress factors caused by DWIBS among women with breast cancer and assess the effectiveness of a new MRI system designed with an environment incorporating relaxing technology.
    METHODS: From May to September 2022, we conducted a questionnaire survey regarding DWIBS-related distress among women with breast cancer. The questionnaire was administered to participants who underwent DWIBS on a conventional MRI system (19 women) and on a new system (20 women) equipped with relaxing technology equipped features, including projection images, illumination, and sound. Participants rated the degree of various stress factors on a face-scale rating scale (0-10). The scores of both systems were compared using the Mann-Whitney U test.
    RESULTS: In the conventional system, women experienced distress due to MRI-specific situations, such as immobility in a confined space, noise, feeling trapped, and concerns about not moving. These results did not show a specific tendency among women with breast cancer undergoing DWIBS. For almost all distress parameters, the new system had significantly lower distress scores than the conventional system (p > 0.05).
    CONCLUSIONS: A comfortable environment using new and relaxing technology is effective in alleviating patient\'s anxiety by approaching the human senses.
    CONCLUSIONS: Reducing distress caused by DWIBS among women with breast cancer could provide a comfortable examination environment, potentially assisting them during longer treatment periods.
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  • 文章类型: Journal Article
    目的:根据周围关节炎症的OMERACT全身MRI评分系统(MRI-WIPE),开发用于髋关节/骨盆区域评分的参考图像图谱。
    方法:我们收集了每种病理的图像示例,位置和等级,在基于网络的情况下讨论了它们,互动会议和,最后,通过共识选择参考图像。
    结果:骨炎每个级别和位置的参考图像,提供滑膜炎和软组织炎症,和定义一样,读者规则和推荐的MRI序列。
    结论:在脊柱关节炎/银屑病关节炎临床试验和队列中,创建了一个参考图像图集来指导髋关节/骨盆区域关节炎和附着性炎的全身MRI评分。
    OBJECTIVE: To develop a reference image atlas for scoring the hip/pelvis region according to the OMERACT whole-body MRI scoring system for inflammation in peripheral joints and entheses (MRI-WIPE).
    METHODS: We collected image examples of each pathology, location and grade, discussed them at web-based, interactive meetings and, finally, selected reference images by consensus.
    RESULTS: Reference images for each grade and location of osteitis, synovitis and soft tissue inflammation are provided, as are definitions, reader rules and recommended MRI-sequences.
    CONCLUSIONS: A reference image atlas was created to guide scoring whole-body MRIs for arthritis and enthesitis in the hip/pelvis region in spondyloarthritis/psoriatic arthritis clinical trials and cohorts.
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