Session Information
Session Type: Abstract Submissions (ACR)
Background/Purpose: BME lesions may change into fatty lesions in the SIJ over time. In one study significant changes of fatty lesions in the SI joints were observed over 1 year in patients with axSpA1. It is unknown if similar results are found with a shorter follow-up period. Therefore we investigate whether BME lesions in the SIJ seen on MRI change into fatty lesions over a 3-month period in patients with axSpA.
Methods: Patients with back pain (≥3 months, ≤2 years, onset <45 years) from the 5 participating centres of the SPondyloArthritis Caught Early (SPACE)-cohort were included. All patients fulfilling the ASAS axSpA criteria underwent MRI-SI at baseline (MRI-SI-baseline) and after 3 months (MRI-SI-3months). MRI-SI-baseline and MRI-SI-3months were scored by 2 well-calibrated readers independently, blinded for time point, for the presence of BME and fatty lesions on STIR and MRI T1-weighted images viewed simultaneously. BME and fatty lesions were defined present if 1 lesion was seen on ≥2 consecutive slices or if >1 lesion were seen on a single slice. The scores of baseline and 3 months were compared on quadrant level (Q) and the sum of all quadrants (8 total) was calculated to obtain patient scores. Scores of the readers are reported separately.
Results: Only axSpA patients with MRI-SI-baseline and MRI-SI-3months were included for this analysis (n=83, number of Q=664). In 62/83 patients (74.7%) reader 1 indicated the presence of BME or fatty lesions at any time point, reader 2 indicated this in 60/83 patients (72.3%). Readers agreed in 73/83 patients (88%) on the presence of lesions at any time point. Reader 1 indicated no lesions at baseline or follow-up in 410/664 Qs (61.7%) and in 131/664 Qs (19.7%) the type of lesions did not change over time. In 123/664 Qs (18.5%) lesions occurred, disappeared or changed from one type to another. In total, there were 34/664 Qs (5.1%) in which fatty lesions occurred, and 29/664 Qs (4.4%) in which fatty lesions disappeared. In only 3/664 Qs (0.5%) BME lesions on MRI-SI-baseline turned into FAT lesions on MRI-SI-3months. In the same amount of Qs the opposite thing is happening; FAT lesions change into BME lesions over time. The results of both readers show similar trends (see table).
Conclusion: We find a lot of volatility of BME and fatty lesions over 3 months time. It is common for both lesions to occur without a previous lesion or disappear completely without leaving a mark, but it is uncommon to see BME lesions turn into fatty lesions over a period of 3 months. This observation casts serious doubts on the value of fatty lesions as a surrogate for previous inflammation.
Reference: 1Song ARD 2011;70:1257-63
|
Reader 1 |
3 months |
||||
|
no lesions |
BME |
FAT |
BME & FAT |
||
|
Baseline
|
no lesions |
410 |
17 |
22 |
1 |
|
BME |
28 |
58 |
3 |
8 |
|
|
FAT |
15 |
3 |
52 |
11 |
|
|
BME & FAT |
7 |
4 |
4 |
21 |
|
|
Reader 2 |
3 months |
||||
|
no lesions |
BME |
FAT |
BME & FAT |
||
|
Baseline
|
no lesions |
395 |
19 |
11 |
0 |
|
BME |
32 |
79 |
4 |
6 |
|
|
FAT |
4 |
5 |
56 |
9 |
|
|
BME & FAT |
3 |
2 |
14 |
25 |
|
Disclosure:
M. de Hooge,
None;
R. van den Berg,
None;
V. Navarro-Compán,
None;
M. Reijnierse,
None;
F. van Gaalen,
None;
K. Fagerli,
None;
R. Landewé,
None;
M. van Oosterhout,
None;
R. Ramonda,
None;
T. Huizinga,
None;
D. van der Heijde,
None.
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ACR Meeting Abstracts - https://acrabstracts.org/abstract/do-bone-marrow-edema-bme-lesions-in-the-sacroiliac-joint-sij-change-into-fatty-lesions-over-a-3-month-period-in-patients-with-axial-spondyloarthritis-axspa/