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Comparing diffusion weighted imaging with clinical and blood parameters, and with short tau inversion recovery sequence in detecting spinal and sacroiliac joint inflammation in axial spondyloarthritis


1, 2, 3, 4, 5, 6, 7, 8, 9, 10

 

  1. Division of Rheumatology and Clinical Immunology, Queen Mary Hospital, Hong Kong, China.
  2. Department of Diagnostic Radiology, The University of Hong Kong, China.
  3. Department of Radiology, Queen Mary Hospital, Hong Kong, China.
  4. Department of Radiology, Queen Mary Hospital, Hong Kong, China.
  5. Division of Rheumatology, Pamela Youde Nethersole Eastern Hospital, Hong Kong, China.
  6. Division of Rheumatology and Clinical Immunology, Queen Mary Hospital, Hong Kong, China.
  7. Division of Rheumatology and Clinical Immunology, Queen Mary Hospital, Hong Kong, China.
  8. Division of Rheumatology and Clinical Immunology, Queen Mary Hospital, Hong Kong, China.
  9. Division of Rheumatology and Clinical Immunology, Queen Mary Hospital, Hong Kong, China.
  10. Department of Radiology, Baptist Hospital, Hong Kong, China. drcswong@gmail.com

CER9478
2017 Vol.35, N°2
PI 0262, PF 0269
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PMID: 27908306 [PubMed]

Received: 03/04/2016
Accepted : 07/09/2016
In Press: 13/11/2016
Published: 15/03/2017

Abstract

OBJECTIVES:
To investigate the usefulness of diffusion weighted imaging (DWI) by comparing with clinical features, blood parameters and traditional short tau inversion recovery (STIR) sequence in detecting spinal and sacroiliac (SI) joint inflammation in axial spondyloarthritis (axSpA) patients.
METHODS:
One hundred and ten axSpA patients were recruited. Clinical, radiological and blood parameters were recorded. DWI and STIR MRI were performed simultaneously and results were scored according to the Spondyloarthritis Research Consortium of Canada (SPARCC) for comparison. Apparent diffusion coef cient (ADC) values were also calculated.
RESULTS:
DWI did not correlate with clinical parameters or blood parameters. It also had lowered sensitivity. When compared with STIR sequence, it correlated well with STIR sequence at the SI joint level (CC 0.76, p<0.001), but weakly at the spinal level (CC 0.23, p=0.02). At the SI joint level, the presence of inflammation on both STIR sequence and DWI was associated with an increase in maximum (B=0.24, p=0.02 in STIR; B=0.37, p<0.001 in DWI) and mean ADC values (B=0.17, p=0.003 in STIR; B=0.15, p=0.01 in DWI). Maximum (B=0.19, p=0.04) and mean spinal ADC values (B=0.18, p=0.01) were also positively associated with DWI detected spinal inflammation. Presence of Modic lesions showed positive correlation with STIR sequence (B=7.12, p=0.01) but not spinal ADC values.
CONCLUSIONS:
Despite DWI correlates with STIR sequence, it has lower sensitivity. However, ADC values appear to be independent of Modic lesions and may supplement STIR sequence to differentiate degeneration.

Rheumatology Article