Ankylosing spondylitis: correlations between clinical and MRI indices of sacroiliitis activity

Zhang, P.; Yu, Kai; Guo, Rui; Shah, Sayed Zulfiqar Ali; Morelli, John N.; Runge, Vivian; Li, X.

doi:10.1016/j.crad.2014.09.015

Cited by 35 publications

(32 citation statements)

References 11 publications

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“…They concluded that the ADC values of lesions were greater than those of the unaffected portions in AS patients. 21 Our study revealed that ADC values of active lesions in patients with axial SpA were significantly higher than the ADC values of unaffected parts of bone marrow in patients with active sacroiliitis as well as the ADC values of bone marrow in patients with chronic back pain that were similar with the majority of the literature. There are slight differences in the ADC values in different studies that may be attributed to the different MRI device and different b values.…”

Section: Discussionsupporting

confidence: 84%

“…There are slight differences in the ADC values in different studies that may be attributed to the different MRI device and different b values. Moreover, similar to the studies of Gezmis et al 6 and Ai et al 15 and unlike the studies of Zhang et al 21 and Sanal et al, 16 the ADC values of unaffected portions of sacroiliac joints in patients with active sacroiliitis were also greater than the ADC values of bone marrow in patients with chronic back pain. This result may be due to the extensive spread of active lesions to the subchondral bone marrow area.…”

Section: Discussionsupporting

confidence: 82%

“…They found that tissue diffusivity and perfusion fraction of intravoxel incoherent motion DWI in AS show a significant difference in the values of diffusion of water molecules and fractional perfusion-related volume among the three groups. 19,20 Furthermore, Zhang et al 21 evaluated 16 healthy controls and 52 patients in their study. They found a statistically significant difference between ADC values of the control and AS groups.…”

Section: Discussionmentioning

confidence: 99%

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Application of Diffusion-Weighted Imaging in the Detection of Active Sacroiliitis and the Comparison of Apparent Diffusion Coefficient and Relative Apparent Diffusion Coefficient Values

et al. 2016

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Objectives: This study aims to evaluate the role of diffusion-weighted imaging in detection of active sacroiliitis and compare the apparent diffusion coefficient (ADC) and normalized relative ADC (r-ADC) values by using vertebra and iliac wings as reference organs. Patients and methods:The study included 56 patients (26 males, 30 females; mean age 37.7±10.1 years; range 18 to 66 years) with chronic back pain and without history of sacroiliitis who underwent magnetic resonance imaging. T2-weighted spectral presaturation with inversion recovery, contrast-enhanced T1-weighted spectral presaturation with inversion recovery, and diffusion-weighted (b values: 0 and 600 s/mm 2 ) images were obtained. All images were evaluated by two different radiologists for interobserver variability. All individuals were grouped in either mechanical low back pain (control group) or active sacroilitis (disease group) groups according to the presence or absence of MRI findings of active sacroilitis. ADC values of both surfaces were measured from normal and affected areas of joints. Also, ADC values of L5 vertebra and iliac wings were measured as reference organs to calculate r-ADC values. Results: Mean ADC and r-ADC values measured from lesions were significantly higher than that of normal appearing bone marrow areas in both patients with mechanical low back pain (n=17) and active sacroiliitis (n=39). Both ADC values and r-ADC values could differentiate active lesions from normal appearing bone marrow areas as well as contrast-enhanced T1-weighted images. According to r-ADC values calculated with the L5 vertebra, unaffected portions of bone marrow areas in patients with sacroiliitis were normalized whereas r-ADC remained higher than normal in affected portions of the bones. Conclusion: Diffusion-weighted imaging is a fast, sensitive magnetic resonance imaging sequence in detection of active sacroiliitis. It does not require contrast agent and can be safely used as an adjunct to conventional magnetic resonance images. r-ADC is also highly sensitive in detecting active sacroiliitis and may be used as an alternative to standard ADC measurements for the demonstration of inflammation. It helps eliminate individual bone marrow differences by using patients' own normal bone marrow measurements and increases diagnostic accuracy.

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Section: Discussionsupporting

confidence: 84%

Section: Discussionsupporting

confidence: 82%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Application of Diffusion-Weighted Imaging in the Detection of Active Sacroiliitis and the Comparison of Apparent Diffusion Coefficient and Relative Apparent Diffusion Coefficient Values

et al. 2016

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“…Conversely, there were a few studies which reported a positive correlation between the SPARCC score of the SIJs and BASDAI score, 21 and between the SPARCC score of the SIJs and ASDAS score. 22 Although the sample sizes of these studies were similar to the current study, the discrepancies in outcomes may be related to different patient baseline conditions such as disease severity.…”

mentioning

confidence: 99%

“…21,22 The primary objective of this study was to investigate the correlation between the MRI disease activity scores and the clinical DAI in Chinese patients with active aSpA who required biologics therapy. In addition, the correlation between MRI disease activity scores of the SIJs and the spine in these patients was assessed.…”

mentioning

confidence: 99%

Intercorrelation between MRI disease activity scores of the sacroiliac joints and the spine, and clinical disease activity indices in patients with axial spondyloarthritis

Lau¹,

Mok²,

Chan³

et al. 2017

RMI

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Objective: To analyze the correlation between the magnetic resonance imaging (MRI) disease activity scores and the clinical disease activity indices (DAI) in Chinese patients with active axial spondyloarthritis (aSpA) that required biologics therapy. The correlation between MRI disease activity scores of the sacroiliac joints (SIJs) and the spine in these patients was also assessed. Methods: This was a cross-sectional study design in which adult patients who fulfilled the Assessment of SpondyloArthritis international Society classification criteria for aSpA and had active disease (Bath Ankylosing Spondylitis Disease Activity Index score ≥4, persistent spinal pain despite nonsteroidal anti-inflammatory drugs therapy >3 months) that required biologics therapy were included. The MRI disease activities were measured using the Spondyloarthritis Research Consortium of Canada (SPARCC) scores. Correlation between the SPARCC scores of the SIJs and the spine, and clinical DAI was calculated. Results: Fifty-seven patients (47 men and 10 women; mean age 37 ± 12 years) completed the study. There was no statistically significant correlation between the SPARCC scores and clinical DAI. The SPARCC score of the SIJs showed a positive correlation with the SPARCC score of the spine (r = 0.34, p < 0.05). The thoracic discovertebral units (57%) were found to be more frequently associated with significant disease activity than the other levels of the spine. Conclusion: MRI can detect active inflammation which may not be reflected by clinical DAI. MRI should be performed in patients with aSpA to provide a more comprehensive assessment and to better reflect disease activity and severity. MRI findings of more severe sacroiliitis should prompt the radiologist to look for involvement in the entire spine, particularly in the thoracic region.

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Assessment of active and inactive sacroiliitis in patients with ankylosing spondylitis using quantitative dynamic contrast-enhanced MRI

Zhang

Zhou

Huang³

et al. 2016

J. Magn. Reson. Imaging

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Ankylosing spondylitis: correlations between clinical and MRI indices of sacroiliitis activity

Cited by 35 publications

References 11 publications

Application of Diffusion-Weighted Imaging in the Detection of Active Sacroiliitis and the Comparison of Apparent Diffusion Coefficient and Relative Apparent Diffusion Coefficient Values

Application of Diffusion-Weighted Imaging in the Detection of Active Sacroiliitis and the Comparison of Apparent Diffusion Coefficient and Relative Apparent Diffusion Coefficient Values

Intercorrelation between MRI disease activity scores of the sacroiliac joints and the spine, and clinical disease activity indices in patients with axial spondyloarthritis

Assessment of active and inactive sacroiliitis in patients with ankylosing spondylitis using quantitative dynamic contrast-enhanced MRI

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