nach oben

Erschienen in:

01.09.2015 | Musculoskeletal

Detection of Active Sacroiliitis with Ankylosing Spondylitis through Intravoxel Incoherent Motion Diffusion-Weighted MR Imaging

verfasst von: Ying-hua Zhao, Shao-lin Li, Zai-yi Liu, Xin Chen, Xiang-cheng Zhao, Shao-yong Hu, Zhen-hua Liu, Ying-jie Mei MS, Queenie Chan, Chang-hong Liang

Erschienen in: European Radiology | Ausgabe 9/2015

Einloggen, um Zugang zu erhalten

Abstract

Objective

To confirm feasibility and assess intravoxel incoherent motion (IVIM) to differentiate active sacroiliitis and ankylosing spondylitis..

Methods

Forty-one patients were divided into two groups, an active group (n = 20) and a chronic group (n = 21), according to the Bath Ankylosing Spondylitis (AS) Disease Activity Index (BASDAI) and laboratory parameters. In addition, 21 healthy volunteers were chosen as the control group. Tissue diffusivity (D_slow), perfusion fraction (f), and pseudo-diffusion coefficient (D_fast) values were obtained for all three groups. One-way analysis of variance and receiver operating characteristic analysis were performed for all parameters.

Results

There was good interobserver agreement on the measurements between the two observers. The optimal cut-off values (with respective AUC, sensitivity, specificity, positive likelihood ratio, and negative likelihood ratio) between active and chronic groups were D_slow = 0.53 × 10⁻³ mm²/s (0.976, 90 %, 95.2 %, 18.9, 0.10) and f = 0.09 (0.545, 20 %, 95.5 %, 4.2, 0.84), and between chronic and control groups were D_slow = 0.22 × 10⁻³ mm²/s (0.517, 9.52 %, 100 %, no number, 0.9) and f = 0.09 (0.935, 95.24 %, 80.95 %, 5, 0.059).

Conclusion

D_slow and f of IVIM diffusion-weighted (DW)-MRI in AS show a significant difference in the values of diffusion of water molecules and fractional perfusion-related volume among the three groups.

Key Points

• D _slow can be used to differentiate the activity of AS.

• With perfusion fraction, the sensitivity of differentiating the AS activity is improved.

• IVIM DWI plays an important role in detecting the activity in patients with AS.

Braun J, Bollow M, Sieper J (1998) Radiologic diagnosis and pathology of the spondyloarthropathies. Rheum Dis Clin N Am 24:697–735CrossRef

Braun J, Baraliakos X, Godolias G, Böhm H (2005) Therapy of ankylosing spondylitis – a review Part I: Conventional medical treatment and surgical therapy. Scand J Rheumatol 34:97–108PubMedCrossRef

Braun J, Baraliakos X, Brandt J et al (2005) Persistent clinical response to the anti-TNF-alpha antibody infliximab in patients with ankylosing spondylitis over 3 years. Rheumatology 44:670–676PubMedCrossRef

Rudwaleit M, Metter A, Listing J, Sieper J, Braun J (2006) Inflammatory back pain in ankylosing spondylitis: a reassessment of the clinical history for application as classification and diagnostic criteria. Arthritis Rheum 54:569–578PubMedCrossRef

Spoorenberg A, van der Heijde D, de Klerk E et al (1999) Relative value of erythrocyte sedimentation rate and C-reactive protein in assessment of disease activity in ankylosing spondylitis. J Rheumatol 26:980–984PubMed

Sheehan NJ, Slavin BM, Donovan MP, Mount JN, Mathews JA (1986) Lack of correlation between clinical disease activity and erythrocyte sedimentation rate, acute phase proteins or protease inhibitors in ankylosing spondylitis. Br J Rheumatol 25:171–174PubMedCrossRef

Zochling J, Braun J, van der Heijde D (2006) Assessments in ankylosing spondylitis. Best Pract Res Clin Rheumatol 20:521–537PubMedCrossRef

Althoff CE, Feist E, Burova E et al (2009) Magnetic resonance imaging of active sacroiliitis: do we really need gadolinium? Eur J Radiol 71:232–236PubMedCrossRef

Gaspersic N, Sersa I, Jevtic V, Tomsic M, Praprotnik S (2008) Monitoring ankylosing spondylitis therapy by dynamic contrast-enhanced and diffusion-weighted magnetic resonance imaging. Skelet Radiol 37:123–131CrossRef

10.

Weber U, Hodler J, Jurik AG et al (2010) Assessment of active spinal inflammatory changes in patients with axial spondyloarthritis: validation of whole body MRI against conventional MRI. Ann Rheum Dis 69:648–653PubMedCrossRef

11.

Braun J, Bollow M, Eggens U et al (1994) Use of dynamic magnetic resonance imaging with fast imaging in the detection of early and advanced sacroiliitis in spondylarthropathy patients. Arthritis Rheum 37:1039–1045PubMedCrossRef

12.

Dallaudiere B, Dautry R, Preux PM et al (2014) Comparison of apparent diffusion coefficient in spondylarthritis axial active inflammatory lesions and type 1 Modic changes. Eur J Radiol 83:366–370PubMedCrossRef

13.

Le Bihan D, Breton E, Lallemand D et al (1986) MR imaging of intravoxel incoherent motions: application to diffusion and perfusion in neurologic disorders. Radiology 161:401–407PubMedCrossRef

14.

Le Bihan D, Turner R, MacFall JR (1989) Effects of intravoxel incoherent motions (IVIM) in steady-state free precession (SSFP) imaging: application to molecular diffusion imaging. Magn Reson Med: Off J Soc Magn Reson Med / Soc Magn Reson Med 10:324–337CrossRef

15.

Patel J, Sigmund EE, Rusinek H et al (2010) Diagnosis of cirrhosis with intravoxel incoherent motion diffusion MRI and dynamic contrast-enhanced MRI alone and in combination: preliminary experience. J Magn Reson Imaging: JMRI 31:589–600PubMedCrossRef

16.

Kang KM, Lee JM, Yoon JH , et al (20130 Intravoxel Incoherent Motion Diffusion-weighted MR Imaging for Characterization of Focal Pancreatic Lesions. Radiology

17.

Tosun M, Inan N, Sarisoy HT , et al (2012) Diagnostic performance of conventional diffusion weighted imaging and diffusion tensor imaging for the liver fibrosis and inflammation. European journal of radiology

18.

Cece H, Gundogan M, Karakas O , et al (2012) The role of diffusion-weighted magnetic resonance imaging in the classification of hepatic hydatid cysts. European journal of radiology

19.

Luciani A, Vignaud A, Cavet M et al (2008) Liver Cirrhosis. Intravoxel Incoherent Motion MR Imaging—Pilot Study1 249:891–899

20.

Chung HY, Lau CS, Wu KP, Wong WS, Mok MY (2011) Comparison of performance of the Assessment of SpondyloArthritis International Society, the European Spondyloarthropathy Study Group and the modified New York criteria in a cohort of Chinese patients with spondyloarthritis. Clin Rheumatol 30:947–953PubMedCentralPubMedCrossRef

21.

Garrett S, Jenkinson T, Kennedy LG et al (1994) A new approach to defining disease status in ankylosing spondylitis: the Bath Ankylosing Spondylitis Disease Activity Index. J Rheumatol 21:2286–2291PubMed

22.

Khoo MM, Tyler PA, Saifuddin A, Padhani AR (2011) Diffusion-weighted imaging (DWI) in musculoskeletal MRI: a critical review. Skelet Radiol 40:665–681CrossRef

23.

Thoeny HC, Zumstein D, Simon-Zoula S et al (2006) Functional evaluation of transplanted kidneys with diffusion-weighted and BOLD MR imaging: initial experience. Radiology 241:812–821PubMedCrossRef

24.

Van Tubergen A, Debats I, Ryser L et al (2002) Use of a numerical rating scale as an answer modality in ankylosing spondylitis-specific questionnaires. Arthritis Rheum 47:242–248PubMedCrossRef

25.

Spoorenberg A, van Tubergen A, Landewe R et al (2005) Measuring disease activity in ankylosing spondylitis: patient and physician have different perspectives. Rheumatology 44:789–795PubMedCrossRef

26.

Rudwaleit M, Baraliakos X, Listing J et al (2005) Magnetic resonance imaging of the spine and the sacroiliac joints in ankylosing spondylitis and undifferentiated spondyloarthritis during treatment with etanercept. Ann Rheum Dis 64:1305–1310PubMedCentralPubMedCrossRef

27.

Braun J, Baraliakos X, Golder W et al (2004) Analysing chronic spinal changes in ankylosing spondylitis: a systematic comparison of conventional x rays with magnetic resonance imaging using established and new scoring systems. Ann Rheum Dis 63:1046–1055PubMedCentralPubMedCrossRef

28.

Provenzale JM, Mukundan S, Barboriak DP (2006) Diffusion-weighted and perfusion MR imaging for brain tumor characterization and assessment of treatment response. Radiology 239:632–649PubMedCrossRef

29.

Fischer M, Bockhorst K, Hoehn-Berlage M, Schmitz B, Hossmann KA (1995) Imaging of the apparent diffusion coefficient for the evaluation of cerebral metabolic recovery after cardiac arrest. Magn Reson Imaging 13:781–790PubMedCrossRef

30.

Koh DM, Collins DJ, Orton MR (2011) Intravoxel incoherent motion in body diffusion-weighted MRI: reality and challenges. AJR Am J Roentgenol 196:1351–1361PubMedCrossRef

31.

Dixon WT (1988) Separation of diffusion and perfusion in intravoxel incoherent motion MR imaging: a modest proposal with tremendous potential. Radiology 168:566–567PubMedCrossRef

32.

Lemke A, Stieltjes B, Schad LR, Laun FB (2011) Toward an optimal distribution of b values for intravoxel incoherent motion imaging. Magn Reson Imaging 29:766–776PubMedCrossRef

33.

Bozgeyik Z, Ozgocmen S, Kocakoc E (2008) Role of diffusion-weighted MRI in the detection of early active sacroiliitis. AJR Am J Roentgenol 191:980–986PubMedCrossRef

34.

Lai V, Li X, Lee VH et al (2014) Nasopharyngeal carcinoma: comparison of diffusion and perfusion characteristics between different tumour stages using intravoxel incoherent motion MR imaging. Eur Radiol 24:176–183PubMedCrossRef

35.

Dawson KL, Moore SG, Rowland JM (1992) Age-related marrow changes in the pelvis: MR and anatomic findings. Radiology 183:47–51PubMedCrossRef

Titel: Detection of Active Sacroiliitis with Ankylosing Spondylitis through Intravoxel Incoherent Motion Diffusion-Weighted MR Imaging
verfasst von: Ying-hua Zhao
Shao-lin Li
Zai-yi Liu
Xin Chen
Xiang-cheng Zhao
Shao-yong Hu
Zhen-hua Liu
Ying-jie Mei MS
Queenie Chan
Chang-hong Liang
Publikationsdatum: 01.09.2015
Verlag: Springer Berlin Heidelberg
Erschienen in: European Radiology / Ausgabe 9/2015
Print ISSN: 0938-7994
Elektronische ISSN: 1432-1084
DOI: https://doi.org/10.1007/s00330-015-3634-2

Update Radiologie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

Newsletter bestellen

Springer Medizin

Detection of Active Sacroiliitis with Ankylosing Spondylitis through Intravoxel Incoherent Motion Diffusion-Weighted MR Imaging