目的:磁共振成像(MRI)的敏感性和特异性在附着性关节炎(ERA)中的研究较少。我们旨在确定骶髂MRI诊断ERA患者的能力。
方法:我们进行了一项回顾性研究,包括44例幼年特发性关节炎(JIA)患者。每位患者均进行骶髂关节MRI检查。我们将患者分为两组:G1期ERA患者和G2期非ERA亚型患者。
结果:在61%的病例中发现了ERA。15例患者(34%)骶髂关节疼痛。25例患者(57%)的MRI正常(G1:11对G2:14),19例(34%)的骶髂关节出现骨髓水肿(G1=16对G2=3,p=0.005)。骶髂关节MRI诊断ERA的敏感性和特异性分别为61.54%和82.35%,分别。阳性预测值和阴性预测值分别为84.21%和58.33%,分别。此外,临床检查中的骶髂关节疼痛能够预测MRI中的骶髂骨水肿,比值比为6.8(95%CI1.68-28.09;p=0.006).
结论:我们的研究表明,在JIA患者中,骶髂关节MRI对ERA患者的诊断具有良好的特异性和阳性预测价值。这强调了骶髂关节MRI在ERA患者的早期诊断中的有用性。
OBJECTIVE: Magnetic resonance imaging (MRI) sensitivity and specificity seem to be less studied in enthesitis-related arthritis (ERA). We aimed to determine the ability of sacroiliac MRI to diagnose ERA patients.
METHODS: We conducted a retrospective study including 44 patients with juvenile idiopathic arthritis (JIA). Each patient had a sacroiliac joint MRI. We divided patients into two groups: G1 patients with ERA and G2 patients with non-ERA subtype.
RESULTS: ERA was noted in 61% of the cases. Sacroiliac joints were painful in 15 patients (34%). MRI was normal in 25 patients (57%) (G1:11 versus G2:14) and showed bone marrow edema in the sacroiliac joints in 19 patients (34%) (G1=16 versus G2=3, p=0.005). Sacroiliac joints MRI\'s sensitivity and specificity in the ERA diagnosis were 61.54% and 82.35%, respectively. Positive and negative predictive values were 84.21% and 58.33%, respectively. Furthermore, sacroiliac joint pain in the clinical examination was able to predict sacroiliac bone edema in MRI with an odds ratio of 6.8 (95% CI 1.68-28.09; p=0.006).
CONCLUSIONS: Our study showed that sacroiliac joint MRI has good specificity and positive predictive value in the diagnosis of ERA patients among JIA patients. This underlines the usefulness of sacroiliac joint MRI in the early diagnosis of ERA patients.