Utilizing MR enterography for detection of sacroiliitis in patients with inflammatory bowel disease

Background To assess the feasibility of diagnosing sacroiliitis on MR enterography examinations (MREs) of patients with inflammatory bowel disease (IBD). Methods Consecutive MREs performed in 286 biopsy proven IBD patients and 48 controls (2005–2012) were retrospectively reviewed for sacroiliitis. A clinical telephone questionnaire focusing on inflammatory back pain (IBP) was conducted in 165 patients and 41 controls. Acute and structural variables were scored in consensus by two readers. Structural changes were also evaluated on computed tomography (CT), when present and correlated to MRE. MRE scores were compared between the study and control groups and between symptomatic and nonsymptomatic patients. Results Mean sacroiliitis score was significantly higher in the study group (Study: 1.1, Control: 0.56, P = 0.015). Sacroiliitis prevalence was 9.1% when bone marrow edema was the diagnostic criterion and increased to 15% when structural changes were added. There was significant correlation between MRE structural score and the presence of structural changes on CT (r = 0.49; P = 0.0001). Thirty‐six patients reported IBP, however, no correlation was found between MRE score and the presence of IBP. Conclusion Acute and structural findings of sacroiliitis can be evaluated on MRE examinations of IBD patients and should be looked for by the evaluating radiologist. J. Magn. Reson. Imaging 2015;42:121–127. © 2014 Wiley Periodicals, Inc.