Magnetic resonance imaging of pelvic entheses - A systematic comparison between short tau inversion recovery (STIR) and T1-weighted, contrast-enhanced, fat-saturated sequences

Eyal Klang, Dvora Aharoni, Kay Geert Hermann, Amir Herman, Uri Rimon, Nachshon Shazar, Iris Eshed

Research output: Contribution to journalArticlepeer-review

6 Scopus citations

Abstract

Objective: To assess the contribution of contrast material in detecting and evaluating enthesitis of pelvic entheses by MRI. Materials and methods: Sixty-seven hip or pelvic 1.5-T MRIs (30:37 male:female, mean age: 53 years) were retrospectively evaluated for the presence of hamstring and gluteus medius (GM) enthesitis by two readers (a resident and an experienced radiologist). Short tau inversion recovery (STIR) and T1-weighted pre- and post-contrast (T1+Gd) images were evaluated by each reader at two sessions. A consensus reading of two senior radiologists was regarded as the gold standard. Clinical data was retrieved from patients' referral form and medical files. Cohen's kappa was used for intra- and inter-observer agreement calculation. Diagnostic properties were calculated against the gold standard reading. Results: A total of 228 entheses were evaluated. Gold standard analysis diagnosed 83 (36 %) enthesitis lesions. Intra-reader reliability for the experienced reader was significantly (p = 0.0001) higher in the T1+Gd images compared to the STIR images (hamstring: k = 0.84/0.45, GM: k = 0.84/0.47). Sensitivity and specificity increased from 0.74/0.8 to 0.87/0.9 in the STIR images and T1+Gd sequences. Intra-reader reliability for the inexperienced reader was lower (p > 0.05). Conclusions: Evidence showing that contrast material improves the reliability, sensitivity, and specificity of detecting enthesitis supports its use in this setting.

Original languageEnglish
Pages (from-to)499-505
Number of pages7
JournalSkeletal Radiology
Volume43
Issue number4
DOIs
StatePublished - 1 Apr 2014
Externally publishedYes

Keywords

  • Contrast material
  • Enthesitis
  • Inflammation
  • MRI
  • Pelvis

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

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