Whole Body MRI Appears To Asses Acute Inflammatory Lesions In Spondylarthritis Patients

According to European and US researchers, Whole-body MRI may help in evaluating acute inflammatory lesions in the sacroiliac joints in patients with established and active spondylarthritis.

The approach, lead investigator Dr. Ulrich Weber told that Whole Body MRI is a promising tool to assess the inflammation load in the entire axial skeleton of SpA patients as opposed to regional exams by conventional MRI.

Dr. Weber of Balgrist University Hospital, Zurich, Switzerland, and colleagues reported the findings after using both methods in 32 patients. The MRIs were then scored by three blinded readers independently in random order.

The performance of whole-body MRI in assessing sacroiliac joint inflammation, continued Dr. Weber, compares well to conventional regional MRI of the sacroiliac joint.

Dr. Weber along with Swiss and Canadian team also reported on whole-body MRI in assessing spinal inflammatory lesions in patients with ankylosing spondylitis or with inflammatory back pain. He noted that the same equivalence has been shown for spinal inflammatory lesions.

The same technique was evaluated in 35 patients with ankylosing spondylitis, 25 with recent-onset back pain and 35 healthy controls. The age of all patients was not more than 45 years.

The images were again interpreted by three blinded readers. The team found that diagnostic utility was optimal when two or more vertebral corner inflammatory lesions were recorded.

For patients with ankylosing spondylitis, the approach provided a sensitivity of 69%, a specificity of 94%, and positive likelihood ratio of 12 where as inn the back pain patients, the values were 32%, 96%, and 8 respectively. In the controls group 9 people had one or more vertebral corner inflammatory lesions, but only two had more than two.

An MRI finding of two or more corner inflammatory lesions in the spine in the age group below 45 years makes a diagnosis of SpA highly probable, Dr. Weber said. Single corner lesions can be misleading, as one quarter of healthy individuals showed such a signal alteration.