Comparison of zero echo time MRI with T1-weighted fast spin echo for the recognition of sacroiliac joint structural lesions using CT as the reference standard.

• ZTE MRI can provide CT-like bone contrast for the depiction of osseous structural lesions of the sacroiliac joints. • ZTE MRI showed superior diagnostic performance than conventional T1 FSE in the detection of osseous structural lesions of sacroiliitis, using CT as the reference standard. • In terms of inter-reader reliability, ZTE MRI performed comparably to CT and better than conventional T1 FSE.