Role of Diffusion-weighted and Contrast-enhanced Magnetic Resonance Imaging in Differentiating Activity of Ankylosing Spondylitis.
- Author:
Ying-Hua ZHAO
1
;
Yan-Yan CAO
2
;
Qun ZHANG
3
;
Ying-Jie MEI
4
;
Ji-Jie XIAO
1
;
Shao-Yong HU
1
;
Wei LI
1
;
Shao-Lin LI
1
Author Information
- Publication Type:Journal Article
- MeSH: Adolescent; Adult; Contrast Media; Diagnosis, Differential; Diffusion Magnetic Resonance Imaging; methods; Female; Humans; Image Enhancement; methods; Magnetic Resonance Imaging; methods; Male; Middle Aged; ROC Curve; Sensitivity and Specificity; Spondylitis, Ankylosing; diagnostic imaging; physiopathology; Young Adult
- From: Chinese Medical Journal 2017;130(11):1303-1308
- CountryChina
- Language:English
-
Abstract:
BACKGROUNDPrevious studies showed that combining apparent diffusion coefficient (ADC) value with the Spondyloarthritis Research Consortium of Canada (SPARCC) index value might provide a reliable evaluation of the activity of ankylosing spondylitis (AS), and that contrast-enhanced (CE) magnetic resonance imaging (MRI) is unnecessary. However, the results were based on confirming only a small random sample. This study aimed to assess the role of CE-MRI in differentiating the disease activity of AS by comparing ADC value with a large sample.
METHODSA total of 115 patients with AS were enrolled in accordance with Bath AS Disease Activity Index and laboratory indices, and 115 patients were divided into two groups, including active group (n = 69) and inactive group (n = 46). SPARCC, ΔSI, and ADC values were obtained from the short tau inversion recovery (STIR), diffusion-weighted imaging (DWI), and CE-MRI, respectively. One-way analysis of variance and receiver operating characteristic analysis were performed for all parameters.
RESULTSThe optimal cutoff values (with sensitivity, specificity, respective area under the curve, positive likelihood ratio, and negative likelihood ratio) for the differentiation between active and inactive groups are as follows: SPARCC = 6 (72.06%, 82.61%, 0.836, 4.14, 0.34); ΔSI (%) = 153 (80.6%, 84.78%, 0.819, 5.3, 0.23); ADC value = 1.15 × 10-3 mm2/s (72.73%, 81.82%, 0.786, 4, 0.33). No statistical differences were found among the predictive values of SPARCC, ΔSI, and ADC. Multivariate analysis showed no significant difference between the combination of SPARCC and ADC values with and without ΔSI.
CONCLUSIONSUsing large sample, we concluded that the combination of STIR and DWI would play significant roles in assessing the disease activity, and CE-MRI sequence is not routinely used in imaging of AS to avoid renal fibrosis and aggravation of kidney disease.