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Intermediate-weighted MRI with fat suppression (IW-FS): diagnostic performance for bone marrow edema and erosion

Min Chen1,2, Keyan Yu1, Xuehan Hu1,2

  • 1Department of Radiology, Peking University Shenzhen Hospital, Shenzhen, PR China.

Acta Radiologica (Stockholm, Sweden : 1987)
|February 7, 2023
PubMed
Abstract

Insights

Intermediate-weighted MRI with fat suppression (IW-FS) shows lower sensitivity for detecting bone marrow edema (BME) compared to T2-STIR. However, IW-FS demonstrates superior sensitivity for identifying sacroiliac joint erosion in axial spondyloarthritis (axSpA).

Area of Science:

  • Radiology
  • Rheumatology
  • Medical Imaging

Background:

  • Bone marrow edema (BME) and sacroiliac joint erosion are crucial MRI indicators for diagnosing axial spondyloarthritis (axSpA).
  • Accurate detection of these lesions is vital for timely diagnosis and management of axSpA.

Purpose of the Study:

  • To compare intermediate-weighted MRI with fat suppression (IW-FS) against T2-weighted short tau inversion recovery (T2-STIR) for assessing sacroiliac BME and erosion in axSpA.
  • To evaluate both qualitative and quantitative differences between the two MRI sequences.

Main Methods:

  • Prospective enrollment of 49 patients (aged 18-60) diagnosed with axSpA.
  • Acquisition of 3.0-T MRI scans including para-coronal IW-FS, T2-STIR, and T1-weighted (T1W) images of the sacroiliac joints.
  • Scoring of BME and erosion using a modified SPARCC system by two blinded readers, with T1W images serving as the reference for erosion.
  • Measurement of signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) for BME.

Main Results:

  • T2-STIR identified BME in more patients (36) compared to IW-FS (29).
  • The mean SPARCC-BME score was lower on IW-FS (11.5) than on T2-STIR (14.7).
  • Both SNR and CNR for BME were significantly lower on IW-FS compared to T2-STIR.
  • IW-FS demonstrated higher sensitivity for detecting sacroiliac joint erosion (83%) than T2-STIR (54%).

Conclusions:

  • IW-FS alone is insufficient for BME detection when T2-STIR is considered the reference standard in axSpA patients.
  • IW-FS offers significantly improved sensitivity for detecting sacroiliac joint erosion compared to T2-STIR.
Keywords:
MR-imagingSkeletal-axialadultsarthritidesjointsmarrow

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