To evaluate the value of adding a volumetric interpolated breath-hold examination (VIBE) sequence to pediatric sacroiliac joint MRI for detecting erosions indicative of juvenile spondyloarthritis (JSpA).
Approach:
Study Design: A prospective study involving 84 children with clinical suspicion of JSpA, comparing MRI results with and without the VIBE sequence.
MRI Protocol: MRI was performed using T1-weighted turbo-spin-echo, short-tau inversion recovery, and VIBE sequences.
Image Review: Three radiologists reviewed the images independently, scoring for erosions, non-erosion bony defects, and overall JSpA indication.
Statistical Analysis: Basic descriptive statistics and interobserver reliability were assessed using Cohen’s Kappa and Light’s kappa.
Key Findings:
Erosions were detected in 12 (14.3%) cases on T1/STIR, 22 (26.2%) on VIBE, and 13 (15.5%) on all sequences.
The global impression of MRI indicative of JSpA was scored as 'yes' in 14 cases (16.7%) on T1/STIR, 21 cases (25.0%) on VIBE, and 15 cases (17.9%) on all sequences.
VIBE was preferred for erosion detection over T1 in 92% of instances where both were assessed.
Interpretation:
The addition of the VIBE sequence enhances the detection of erosions in pediatric SIJ MRI, potentially improving diagnostic accuracy for JSpA.
Limitations:
The study was limited to a single institution, which may affect generalizability.
The sample size may not be sufficient to draw definitive conclusions.
Conclusion:
Incorporating a high-resolution 3D VIBE sequence in pediatric SIJ MRI may improve the identification of erosions indicative of JSpA.
