Can T1W and T2W Dixon Sequences Replace the Standard MRI Protocol in Diagnosing Sacroiliitis?

Objectives: This study aims to assess the performances of T1-weighted (T1W) and T2-weighted (T2W) Dixon sequences as replacements for the standard magnetic resonance imaging (MRI) protocol for diagnosing active and chronic sacroiliitis. Materials/Methods: This single-centre, prospective study includ...

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Main Authors: Nur Betül Karatoprak, Zeynep Maraş Özdemir, Sinan Karatoprak, Ayşegül Sağır Kahraman, Leyla Karaca, Servet Yolbaş
Format: Article
Language:English
Published: Ubiquity Press 2024-12-01
Series:Journal of the Belgian Society of Radiology
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Online Access:https://account.jbsr.be/index.php/up-j-jbsr/article/view/3658
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author Nur Betül Karatoprak
Zeynep Maraş Özdemir
Sinan Karatoprak
Ayşegül Sağır Kahraman
Leyla Karaca
Servet Yolbaş
author_facet Nur Betül Karatoprak
Zeynep Maraş Özdemir
Sinan Karatoprak
Ayşegül Sağır Kahraman
Leyla Karaca
Servet Yolbaş
author_sort Nur Betül Karatoprak
collection DOAJ
description Objectives: This study aims to assess the performances of T1-weighted (T1W) and T2-weighted (T2W) Dixon sequences as replacements for the standard magnetic resonance imaging (MRI) protocol for diagnosing active and chronic sacroiliitis. Materials/Methods: This single-centre, prospective study included 107 patients who underwent 3 Tesla MRIs. The patients with inflammatory low-back pain (aged 18–50 years) were included. The exclusion criteria included pregnancy, pelvic infection/malignancy history, pelvic metal implants or foreign body artefacts. The imaging protocol comprised standard T1W and T2W fat-saturated (T2W-FS) sequences and T1W–T2W Dixon sequences. Active sacroiliitis signs were assessed by comparing T2W-FS images with T2W Dixon water-only (WO) images. Chronic sacroiliitis signs were evaluated by comparing the standard T1W sequence with T1W–T2W Dixon fat-only (FO), in-phase (IP) and out-of-phase (OP) images. The quantitative analysis involved calculating signal-to-noise ratios (SNRs) and contrast-to-noise ratios (CNRs) for bone marrow edema (BME) and periarticular fat deposition (PFD). Descriptive statistics, correlation, diagnostic performance tests and interobserver reliability tests were performed in the qualitative analysis. Results: There were no statistically significant differences in BME detection between the T2W-FS and T2W Dixon-WO images. T2W Dixon exhibited significantly greater SNRs–CNRs than did the standard protocol for BME and periarticular fat deposition assessments. T1W–T2W Dixon imaging demonstrated sufficiently high diagnostic performance for detecting erosions, periarticular fat deposition and ankylosis compared with the standard protocol. Conclusions: The T2W Dixon sequence has the potential to replace the standard protocol, which would reduce acquisition time. However, we do not recommend the use of the T1W Dixon sequence in routine practice, since standard T1W images provide similar or superior results to T1W Dixon images.
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issn 2514-8281
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publishDate 2024-12-01
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series Journal of the Belgian Society of Radiology
spelling doaj-art-0e42d500fae34cb8910de17a46d04c9a2025-01-08T07:57:57ZengUbiquity PressJournal of the Belgian Society of Radiology2514-82812024-12-01108111111110.5334/jbsr.36583654Can T1W and T2W Dixon Sequences Replace the Standard MRI Protocol in Diagnosing Sacroiliitis?Nur Betül Karatoprak0Zeynep Maraş Özdemir1Sinan Karatoprak2Ayşegül Sağır Kahraman3Leyla Karaca4Servet Yolbaş5Department of Radiology, Kayseri City Training and Research HospitalFaculty of Medicine, Department of Radiology, İnönü UniversityDepartment of Radiology, Kayseri City Training and Research HospitalFaculty of Medicine, Department of Radiology, İnönü UniversityFaculty of Medicine, Department of Radiology, İnönü UniversityFaculty of Medicine, Departments of Internal Medicine, İnönü UniversityObjectives: This study aims to assess the performances of T1-weighted (T1W) and T2-weighted (T2W) Dixon sequences as replacements for the standard magnetic resonance imaging (MRI) protocol for diagnosing active and chronic sacroiliitis. Materials/Methods: This single-centre, prospective study included 107 patients who underwent 3 Tesla MRIs. The patients with inflammatory low-back pain (aged 18–50 years) were included. The exclusion criteria included pregnancy, pelvic infection/malignancy history, pelvic metal implants or foreign body artefacts. The imaging protocol comprised standard T1W and T2W fat-saturated (T2W-FS) sequences and T1W–T2W Dixon sequences. Active sacroiliitis signs were assessed by comparing T2W-FS images with T2W Dixon water-only (WO) images. Chronic sacroiliitis signs were evaluated by comparing the standard T1W sequence with T1W–T2W Dixon fat-only (FO), in-phase (IP) and out-of-phase (OP) images. The quantitative analysis involved calculating signal-to-noise ratios (SNRs) and contrast-to-noise ratios (CNRs) for bone marrow edema (BME) and periarticular fat deposition (PFD). Descriptive statistics, correlation, diagnostic performance tests and interobserver reliability tests were performed in the qualitative analysis. Results: There were no statistically significant differences in BME detection between the T2W-FS and T2W Dixon-WO images. T2W Dixon exhibited significantly greater SNRs–CNRs than did the standard protocol for BME and periarticular fat deposition assessments. T1W–T2W Dixon imaging demonstrated sufficiently high diagnostic performance for detecting erosions, periarticular fat deposition and ankylosis compared with the standard protocol. Conclusions: The T2W Dixon sequence has the potential to replace the standard protocol, which would reduce acquisition time. However, we do not recommend the use of the T1W Dixon sequence in routine practice, since standard T1W images provide similar or superior results to T1W Dixon images.https://account.jbsr.be/index.php/up-j-jbsr/article/view/3658sacroiliitismagnetic resonance imagingchemical shift imaging
spellingShingle Nur Betül Karatoprak
Zeynep Maraş Özdemir
Sinan Karatoprak
Ayşegül Sağır Kahraman
Leyla Karaca
Servet Yolbaş
Can T1W and T2W Dixon Sequences Replace the Standard MRI Protocol in Diagnosing Sacroiliitis?
Journal of the Belgian Society of Radiology
sacroiliitis
magnetic resonance imaging
chemical shift imaging
title Can T1W and T2W Dixon Sequences Replace the Standard MRI Protocol in Diagnosing Sacroiliitis?
title_full Can T1W and T2W Dixon Sequences Replace the Standard MRI Protocol in Diagnosing Sacroiliitis?
title_fullStr Can T1W and T2W Dixon Sequences Replace the Standard MRI Protocol in Diagnosing Sacroiliitis?
title_full_unstemmed Can T1W and T2W Dixon Sequences Replace the Standard MRI Protocol in Diagnosing Sacroiliitis?
title_short Can T1W and T2W Dixon Sequences Replace the Standard MRI Protocol in Diagnosing Sacroiliitis?
title_sort can t1w and t2w dixon sequences replace the standard mri protocol in diagnosing sacroiliitis
topic sacroiliitis
magnetic resonance imaging
chemical shift imaging
url https://account.jbsr.be/index.php/up-j-jbsr/article/view/3658
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