High-resolution 3D VIBE boosts confidence but not accuracy in pediatric SIJ MRI for JSpA

Adding a 3D VIBE sequence to T1/STIR MRI in children with suspected juvenile spondyloarthritis boosted reader confidence (consensus sensitivity 38.5%, specificity 94.8%) but did not significantly improve diagnostic accuracy.

• Prospective study of 84 children (mean age 13.3y) with suspected JSpA; three radiologists read in three exercises (T1/STIR only, VIBE only, all sequences).
• VIBE substantially increased detection of non-erosion bony defects (94% vs 51% on T1/STIR), highlighting the need to interpret all sequences together to avoid overdiagnosis.
• Inter-reader agreement did not consistently improve despite significantly increased confidence scores.

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