Mono-exponential and bi-exponential model-based diffusion-weighted MR imaging and IDEAL-IQ sequence for quantitative evaluation of sacroiliitis in patients with ankylosing spondylitis
- 192 Downloads
To evaluate the utility of mono-exponential and bi-exponential model-based diffusion-weighted MR imaging and IDEAL-IQ sequence for differentiating the activity of sacroiliitis in ankylosing spondylitis (AS). AS patients were divided into active group (n = 30) and inactive group (n = 28) according to Ankylosing Spondylitis Disease Activity Score (ASDAS) with C-reactive protein (CRP). In addition, 30 healthy volunteers were chosen as healthy group. Subjects were scanned by conventional MRI, diffusion-weighted imaging, and IDEAL-IQ sequence. Apparent diffusion coefficient (ADC), true diffusion coefficient (D), pseudodiffusion coefficient (D*), perfusion fraction (f), and fat fraction (FF) values were measured, and their relative values (rADC, rD, rD*, rf) were calculated by the formula ADC (D,D*,f)lesion/ADC (D,D*,f)reference, respectively. The ADC, D, rADC, and rD of active group were the highest among the three groups, followed by inactive and healthy group. However, D* and rD* showed no significant difference among the three groups. FF was significantly higher in inactive group than in healthy and active group. ADC and D had significantly higher AUCs than f for differentiating active group from healthy group, while FF had the highest AUC for distinguishing inactive sacroiliitis from healthy group. DWI and IDEAL-IQ imaging are helpful in quantitatively assessing the activity of sacroiliitis in AS patients.
KeywordsAnkylosing spondylitis Diffusion-weighted MR imaging IDEAL-IQ Sacroiliitis
This study was supported by the National Scientific Foundation of China (No. 81701648).
Compliance with ethical standards
This prospective study was approved by Institute Ethics Committee and written informed consent was obtained from all participants.
- 6.Maksymowych WP, Inman RD, Salonen D, Dhillon SS, Williams M, Stone M, Conner-spady B, Palsat J, Lambert RGW (2005) Spondyloarthritis research consortium of Canada magnetic resonance imaging index for assessment of sacroiliac joint inflammation in ankylosing spondylitis. Arthritis Rheum 53:703–709CrossRefPubMedCentralGoogle Scholar
- 9.Suh CH, Yun SJ, Jin W, Lee SH, Park SY, Ryu CW (2018) ADC as a useful diagnostic tool for differentiating benign and malignant vertebral bone marrow lesions and compression fractures: a systematic review and meta-analysis. Eur Radiol 28:2890–2902. https://doi.org/10.1007/s00330-018-5330-5 CrossRefPubMedPubMedCentralGoogle Scholar
- 10.Park S, Kwack KS, Chung N, Hwang J, Lee HY, Kim JH (2017) Intravoxel incoherent motion diffusion-weighted magnetic resonance imaging of focal vertebral bone marrow lesions: initial experience of the differentiation of nodular hyperplastic hematopoietic bone marrow from malignant lesions. Skelet Radiol 46:675–683CrossRefGoogle Scholar
- 17.Baraliakos X, Heldmann F, Callhoff J, Listing J, Appelboom T, Brandt J, van den Bosch F, Breban M, Burmester GR, Dougados M, Emery P, Gaston H, Grunke M, van der Horst-Bruinsma IE, Landewé R, Leirisalo-Repo M, Sieper J, de Vlam K, Pappas D, Kiltz U, van der Heijde D, Braun J (2014) Which spinal lesions are associated with new bone formation in patients with ankylosing spondylitis treated with anti-TNF agents? A long-term observational study using MRI and conventional radiography. Ann Rheum Dis 73:1819–1825CrossRefPubMedCentralGoogle Scholar
- 29.Wang F, Wang Y, Zhou Y, Liu C, Xie L, Zhou Z, Liang D, Shen Y, Yao Z, Liu J (2017) Comparison between types I and II epithelial ovarian cancer using histogram analysis of monoexponential, biexponential, and stretched-exponential diffusion models. J Magn Reson Imaging 46:1797–1809CrossRefPubMedCentralGoogle Scholar
- 33.Andreou A, Koh DM, Collins DJ, Blackledge M, Wallace T (2013) Leach MO,et al. measurement reproducibility of perfusion fraction and pseudodiffusion coefficient derived by intravoxel incoherent motion diffusion-weighted MR imaging in normal liver and metastases. Eur Radiol 23:428–434CrossRefPubMedCentralGoogle Scholar
- 36.Machado PM, Baraliakos X, van der Heijde D, Braun J, Landewé R (2016) MRI vertebral corner inflammation followed by fat deposition is the strongest contributor to the development of new bone at the same vertebral corner: a multilevel longitudinal analysis in patients with ankylosing spondylitis. Ann Rheum Dis 75:1486–1493CrossRefGoogle Scholar