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Quantification of bone marrow oedema and fat metaplasia in sacroiliac joints in spondyloarthritis patients using histographic magnetic resonance imaging analysis


1, 2, 3, 4, 5, 6

 

  1. Rheumatology Clinic, Università Politecnica delle Marche, Dipartimento Di Scienze Cliniche e Molecolari, Ospedale Carlo Urbani, Jesi, Italy.
  2. U.O. di Radiologia, Ospedale degli Infermi, Azienda AUSL della Romagna, Faenza, Italy.
  3. Dipartimento di Scienze Radiologiche, Ospedali Riuniti, Università Politecnica delle Marche, Ancona, Italy.
  4. Rheumatology Clinic, Università Politecnica delle Marche, Dipartimento Di Scienze Cliniche e Molecolari, Ospedale Carlo Urbani, Jesi, Italy. dica.marco@yahoo.it
  5. Rheumatology Clinic, Università Politecnica delle Marche, Dipartimento Di Scienze Cliniche e Molecolari, Ospedale Carlo Urbani, Jesi, Italy.
  6. Dipartimento di Scienze Radiologiche, Ospedali Riuniti, Università Politecnica delle Marche, Ancona, Italy.

CER14819
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PMID: 34596031 [PubMed]

Received: 20/05/2021
Accepted : 30/08/2021
In Press: 28/09/2021

Abstract

OBJECTIVES:
To demonstrate a possible basis for a quantitative magnetic resonance imaging (MRI) approach that uses histographic analysis to determine bone marrow oedema (BME) and fat metaplasia at sacroiliac joints (SIJs) level in patients with axial spondyloarthritis (axSpA).
METHODS:
In this prospective, cross-sectional study, consecutive axSpA patients with inflammatory low back pain underwent 1.5-T MRI. MRI images were scored on a 4-point (0–3) scoring system both for BME and fat metaplasia by two radiologists. A region-of-interest based histographic quantitative analysis was used to assess MRI images. Using the area under the receiver operating characteristic curve (AUC-ROC) approach was tested the diagnostic accuracy of histographic analysis for detecting BME vs. BME and fat metaplasia on MRI images.
RESULTS:
17 of the 43 patients (39.5%) included only had a BME lesion, while the remaining 26 patients (60.5%) had both BME and fat metaplasia at the SIJ level. Inter-rater agreement between readers was good (weighted kappa 0.643). On MRI images, BME and BME+fat metaplasia showed significant difference in histographic analysis (p<0.001), with an AUC-ROC of 0.898, and an optimal cut-off point of 311 at histographic analysis in the distinction of BME vs. fat metaplasia.
CONCLUSIONS:
Histographic analysis could represent a method for quantifying BME on MRI images of SIJs in patients with axSpA. This type analysis can provide important prognostic information and guide the choice of treatment in patients with sacroiliitis.

Rheumatology Article