The application of T2W SPIR-FLAIR in the diagnosis of hip synovitis in patients with spondyloarthritis

Zhenguo, Huang; Chen, Xiaoliang; Shi, Kun; Yan, Rong; Chen, He; Yang, Ming; Gao, Bao-xiang; Chan, Queenie; Wang, Guochun

doi:10.1259/bjr.20160566

Cited by 3 publications

(6 citation statements)

References 22 publications

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“…The BASRI-h method is performed based on structural damage, which may not sensitively reflect the treatment effect in patients during early and acute inflammation stages in short-time follow-up. Comparatively, MRI is considered to be a more sensitive assessment tool for hip inflammation and is especially helpful in early diagnosis ( 8 , 23 , 27 ).…”

Section: Discussionmentioning

confidence: 99%

“…Recent studies have shown that synovial enhancement with hyperintense signals on contrast-enhanced T1-weighted images is the most frequent imaging finding in early-stage hip involvement in AS ( 14 ). Joint effusion of the femoral neck and subchondral BME are frequent findings with hyperintense signals on T2-weighted images or STIR images ( 8 , 27 ). However, lesion frequency analysis or description of characteristics cannot quantitatively reflect MRI changes under treatment.…”

Section: Discussionmentioning

confidence: 99%

“…MRI has been widely used as a sensitive tool to detect hip arthritis. MRI is helpful for early diagnosis to enable treatment to suppress inflammation and avoid further structural damage ( 8 , 9 ). The Hip Inflammation MRI Scoring System (HIMRISS) is a new quantitative assessment method that is based on several MRI slices from one patient.…”

Section: Introductionmentioning

confidence: 99%

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The Clinical and MRI Effect of TNF-α Inhibitors in Spondyloarthritis Patients With Hip Involvement: A Real-World Observational Clinical Study

et al. 2021

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ObjectivesHip involvement is an important cause of disability and poor prognosis in patients with spondyloarthritis (SpA). Tumor necrosis factor (TNF)-α inhibitor treatment has been demonstrated to be effective in SpA patients with hip arthritis; however, quantitative assessment using MRI in long-term follow-up needs further application and observation.MethodsA total of 239 patients were involved in this study. Methotrexate and sulfasalazine were given as basic treatment. In total, 165 patients received TNF-α inhibitors plus basic treatment, and 74 received basic treatment only, as controls. Clinical symptoms were assessed at baseline and at weeks 12, 24, and 52. MRI performances of hip arthritis, including bone marrow edema (BME) and synovitis, were quantitatively assessed using the Hip Inflammation MRI Scoring System (HIMRISS).ResultsThe clinical values of erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), Harris hip score, and Ankylosing Spondylitis Disease Activity Score (ASDAS)-ESR in both groups showed significant clinical remission at week 52 (p < 0.001). However, the change in disease activity levels at week 52 in the control group was significantly worse than in the TNF-α inhibitor group. At week 52, MRI showed a significant remission trend in the TNF-α inhibitor group versus baseline, and total HIMRISS scores were significantly decreased (26.49 ± 10.37 vs. 20.59 ± 9.41, p < 0.001); the control group only had slight improvement (p < 0.05).ConclusionsTNF-α inhibitors could significantly improve clinical and MRI manifestations of hip involvement in patients with SpA. Quantitative MRI assessment combined with clinical assessment can be used to accurately evaluate the treatment effect of TNF-α in SpA patients with hip involvement to help guide targeted treatment.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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The Clinical and MRI Effect of TNF-α Inhibitors in Spondyloarthritis Patients With Hip Involvement: A Real-World Observational Clinical Study

et al. 2021

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“…Magnetic resonance imaging (MRI) has been widely used and proven to be a sensitive tool for detecting early inflammation before structural damage (Huang et al, 2016;Krabbe et al, 2020). Quantitative evaluation of MRI lesions of hip inflammation may facilitate early detection and precise assessment of disease progression (Zhang et al, 2021).…”

Section: Introductionmentioning

confidence: 99%

Deep-learning based quantification model for hip bone marrow edema and synovitis in patients with spondyloarthritis based on magnetic resonance images

Zheng

Bai²,

Zhang³

et al. 2023

Front. Physiol.

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Objectives: Hip inflammation is one of the most common complications in patients with spondyloarthritis (SpA). Herein, we employed use of a deep learning-based magnetic resonance imaging (MRI) evaluation model to identify irregular and multiple inflammatory lesions of the hip.Methods: All of the SpA patients were enrolled at the Xijing Hospital. The erythrocyte sediment rate (ESR), C-reactive protein (CRP), hip function Harris score, and disease activity were evaluated by clinicians. Manual MRI annotations including bone marrow edema (BME) and effusion/synovitis, and a hip MRI scoring system (HIMRISS) assessment was performed by experienced musculoskeletal radiologists. The segmentation accuracies of four deep learning models, including U-Net, UNet++, Attention-Unet, and HRNet, were compared using five-fold cross-validation. The clinical agreement of U-Net was evaluated with clinical symptoms and HIMRISS results.Results: A total of 1945 MRI slices of STIR/T2WI sequences were obtained from 195 SpA patients with hip involvement. After the five-fold cross-validation, U-Net achieved an average segmentation accuracy of 88.48% for the femoral head and 69.36% for inflammatory lesions, which are higher than those obtained by the other three models. The UNet-score, which was calculated based on the same MRI slices as HIMRISS, was significantly correlated with the HIMRISS scores and disease activity indexes (p values <0.05).Conclusion: This deep-learning based automatic MRI evaluation model could achieve similar quantification performance as an expert radiologist, and it has the potential to improve the accuracy and efficiency of clinical diagnosis for SpA patients with hip involvement.

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“…Diagnostics 2023, 13,1960 2 of 14 Signals from both joint fluid and fat are suppressed by a combination of FLAIR and fat suppression, thereby improving the conspicuity of the synovium [10]. The feasibility of FLAIR-FS for the assessment of knee or hip synovitis has been demonstrated in previous studies [10][11][12]. However, to the best of our knowledge, no previous study has applied the FLAIR-FS to the assessment of ankle synovitis.…”

Section: Introductionmentioning

confidence: 99%

Fluid-Attenuated Inversion Recovery Sequence with Fat Suppression for Assessment of Ankle Synovitis without Contrast Enhancement: Comparison with Contrast-Enhanced MRI

et al. 2023

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The purpose of this study was to investigate the feasibility of the fluid-attenuated inversion recovery sequence with fat suppression (FLAIR-FS) for the assessment of ankle synovitis without contrast enhancement. FLAIR-FS and contrast-enhanced, T1-weighted sequences (CE-T1) of 94 ankles were retrospectively reviewed by two radiologists. Grading of synovial visibility (four-point scale) and semi-quantitative scoring of synovial thickness (three-point scale) were performed in four compartments of the ankle in both sequences. Synovial visibility and thickness in FLAIR-FS and CE-T1 images were compared, and agreement between both sequences was assessed. Synovial visibility grades and synovial thickness scores for FLAIR-FS images were lower than those for CE-T1 images (reader 1, p = 0.016, p < 0.001; reader 2, p = 0.009, p < 0.001). Dichotomized synovial visibility grades (partial vs. full visibility) were not significantly different between both sequences. The agreement in synovial thickness scores between the FLAIR-FS and CE-T1 images was moderate to substantial (κ = 0.41–0.65). The interobserver agreement between the two readers was fair for synovial visibility (κ = 0.27–0.32) and moderate to substantial for synovial thickness (κ = 0.54–0.74). In conclusion, FLAIR-FS is a feasible MRI sequence for the evaluation of ankle synovitis without contrast enhancement.

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The application of T2W SPIR-FLAIR in the diagnosis of hip synovitis in patients with spondyloarthritis

Cited by 3 publications

References 22 publications

The Clinical and MRI Effect of TNF-α Inhibitors in Spondyloarthritis Patients With Hip Involvement: A Real-World Observational Clinical Study

The Clinical and MRI Effect of TNF-α Inhibitors in Spondyloarthritis Patients With Hip Involvement: A Real-World Observational Clinical Study

Deep-learning based quantification model for hip bone marrow edema and synovitis in patients with spondyloarthritis based on magnetic resonance images

Fluid-Attenuated Inversion Recovery Sequence with Fat Suppression for Assessment of Ankle Synovitis without Contrast Enhancement: Comparison with Contrast-Enhanced MRI

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