脊柱MRI阳性发现的候选定义对于临床诊断

脊柱MRI阳性发现的候选定义对于临床诊断nr-axSpA的效用

WeberU,etal.ArthritisRheumatol.Apr;67(4):-33.

原文

Diagnosticutilityofcandidatedefinitionsfordemonstratingaxialspondyloarthritisonmagneticresonanceimagingofthespine.

OBJECTIVE:Arecentconsensusstatementhassuggested≥3cornerinflammatorylesions(CILs)orseveralcornerfattylesions(CFLs)ascandidatecriteriaindicativeofaxialspondyloarthritis(SpA)onmagneticresonanceimaging(MRI)ofthespine.TheaimofthisstudywastoevaluatethediagnosticutilityofthesecutoffsinnonradiographicaxialSpAandankylosingspondylitis(AS).

METHODS:Onehundredthirtyconsecutivepatientswithbackpainwhowere≤50yearsofageandnewlyreferredto2universityclinics(cohortsAandB)wereclassifiedaccordingtorheumatologistexpertopinionbasedonresultsofclinicalexaminationandpelvicradiographyashavingnonradiographicaxialSpA(n=50),AS(n=33),ornonspecificbackpain(n=47).CohortAalsoincluded20age-matchedhealthycontrols.FourblindedreadersassessedMRIsofthespineusingthestandardizedCanada-Denmarkmodule.ReadersrecordedCILsandCFLsin23discovertebralunits.Wetestedthediagnosticutility(meansensitivityandspecificityover4readers)ofthecutoffforthenumberoflesionsonspinalMRIasproposedintheliterature(≥2or≥3CILsand≥6CFLs),andwetestedforpossiblethresholds(from≥1CILorCFLto≥10CILsorCFLs)fornonradiographicaxialSpAandASpatientsinbothcohorts.

RESULTS:Noneofthespinalthresholds(≥2or≥3CILsand≥6CFLs)showedclinicallyrelevantdiagnosticutility(positivelikelihoodratio[LR]range1.38-2.36)when







































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