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Grading der Sakroiliitis mit Betonung der MRT-Bildgebung

  • Sakroiliakalgelenk
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Zusammenfassung

Schnittbildverfahren spielen bei der Identifizierung, Lokalisation und Charakterisierung von Veränderungen des Sakroiliakalgelenks (SIG) im Frühstadium der seronegativen Spondylarthropathie (SpA) eine entscheidende Rolle. Obwohl mehrere Studien zeigten, dass der diagnostische Wert der MRT und CT jenem der konventionellen Radiographie überlegen ist, hat sich das Schnittbildverfahren als Mittel zur Evaluierung des Grades der ankylosierenden Spondylitis (AS) im Gegensatz zur konventionellen Radiographie noch nicht etabliert und durchgesetzt.

Dieses Fehlen eines akzeptierten MRT- und/oder CT-Verfahrens zur Evaluierung und zum Grading der Veränderungen am SIG macht es schwierig, die Ergebnisse dieser Verfahren bei der Einstufung des Grades der AS-Veränderungen und Erarbeitung von Diagnosekriterien für andere Formen der SpA einzubeziehen. Außerdem wird das Grading der SIG-Veränderungen bei SpA mit einer sensitiveren Methode als der konventionellen Radiographie bei der Evaluation der Therapie von großer Wichtigkeit sein, wie z. B. die Wirksamkeit neuer biologischer Therapeutika, die gegen den Tumornekrosefaktor-α (TNF-α) gerichtet sind.

Es wird ein Überblick über die verfügbaren Gradingmethoden gegeben und MRT- und CT-Verfahren werden präsentiert.

Abstract

Cross-sectional imaging techniques play a decisive role in identification, localization, and characterization of alterations in the sacroiliac joint during the early stage of seronegative spondylarthropathy (SpA). Although several studies showed that the diagnostic capabilities of MRI and CT are superior to those of conventional radiography, they have not yet become established and accepted as methods for evaluating the grade of ankylosing spondylitis (AS) in contrast to conventional radiography.

The lack of acceptance for MRI and/or CT methods for evaluating and grading changes in the sacroiliac joint makes it difficult to include the results of these procedures in classifying the grade of SpA. Moreover, grading the changes in the sacroiliac joint in SpA with a method more sensitive than conventional radiography will be of prime importance in assessing treatment, e.g., the efficacy of new biological therapeutic agents directed against the tumor necrosis factor-alpha (TNF-α).

An overview of the available grading methods is provided and MRI and CT techniques are presented.

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Authors and Affiliations

  1. The Department of Radiology R, Aarhus Kommunehospital

    A. G. Jurik & N. Egund

  2. Department of Radiology R, Aarhus Kommunehospital, Noerrebrogade 44, DK 8000 , Aarhus C, Denmark

    A. G. Jurik

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  1. A. G. Jurik
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  2. N. Egund
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Correspondence to A. G. Jurik.

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Jurik, A.G., Egund, N. Grading der Sakroiliitis mit Betonung der MRT-Bildgebung. Radiologe 44, 234–241 (2004). https://doi.org/10.1007/s00117-003-1017-1

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