MRI grading method for active and chronic spinal changes in spondyloarthritis

Area of Science:

• Rheumatology
• Radiology
• Medical Imaging

Background:

• Spondyloarthritis (SpA) is a group of inflammatory diseases affecting the spine.
• Accurate assessment of active and chronic spinal changes in SpA is crucial for patient management.
• Current imaging modalities have limitations in fully characterizing SpA-related spinal pathology.

Purpose of the Study:

• To develop and validate a magnetic resonance imaging (MRI) grading system for active and chronic spinal changes in spondyloarthritis (SpA).
• To assess the reliability of the proposed MRI grading method.
• To compare MRI findings of chronic changes with radiographic assessments.

Main Methods:

• 91 patients with SpA underwent spinal MRI and radiography.
• MRI assessed bone marrow edema (activity) and syndesmophytes, erosion, fatty marrow deposition (FMD) (chronic changes).
• Interobserver agreement for MRI was analyzed; MRI scores were compared with radiographic findings.

Main Results:

• The MRI grading method demonstrated acceptable interobserver agreement (kappa 0.62-0.77).
• 56 patients showed SpA-related spinal abnormalities on MRI.
• Chronic MRI scores did not correlate significantly with radiographic scores, but FMD correlated with radiographic scores and vertebral squaring.

Conclusions:

• The developed MRI grading system is reliable for evaluating active and chronic SpA spinal disease.
• MRI shows promise for assessing chronic changes, with FMD being a significant indicator of chronicity.
• Cervical radiography may remain necessary for comprehensive assessment in some cases.