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

  • Musculoskeletal
  • Published:
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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 (Dslow), perfusion fraction (f), and pseudo-diffusion coefficient (Dfast) 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 Dslow = 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 Dslow = 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

Dslow 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.

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Abbreviations

AS:

Ankylosing spondylitis

AUC:

Area under the curve

Dslow :

Pure diffusion

Dfast :

Pseudo diffusion coefficient

F:

Perfusion fraction

DWI:

Diffusion-weighted imaging

ADC:

Apparent diffusion coefficient

IVIM:

Intravoxel incoherent motion

ROC:

Receiver operating characteristic

ROI:

Region of interest

SDS:

Standard deviation

SNR:

Signal-to-noise ratio

DCE-MRI:

Dynamic contrast-enhanced MR imaging

SPIR:

Spectral presaturation inversion recovery

PDW-SPAIR:

Proton density-weighted spectral presaturation attenuated inversion recovery

STIR:

Short tau inversion recovery

TR/TE:

Repetition time/echo

TSE:

Turbo spin echo

FSE:

Fast spin echo

FS:

Fat suppression

ESR:

Erythrocyte sedimentation rate

CRP:

C-reactive protein

MRI:

Magnetic resonance imaging

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Acknowledgements

The scientific guarantor of this publication is Changhong Liang. The authors of this manuscript declare no relationships with any companies, whose products or services may be related to the subject matter of the article. This study has received funding by the National Scientific Foundation of China (No. 81271569, U1301258 and 81271654) and the Medical Scientific Foundation of Guangzhou city, Guangdong Province, China (No. 20121A011181). One of the authors has significant statistical expertise. Institutional review board approval was obtained. Written informed consent was obtained from all subjects (patients) in this study. Methodology: prospective, case-control study, multicenter study.

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Authors and Affiliations

  1. Department of Radiology, Third Affiliated Hospital of Southern Medical University, Academy of Orthopedics, 183 Zhongshan Da Dao Xi, Guangdong Province, Guangzhou, 510630, China

    Ying-hua Zhao, Shao-lin Li, Xiang-cheng Zhao, Shao-yong Hu & Zhen-hua Liu

  2. Department of Radiology, Guangdong General Hospital, Guangdong Academy of Medical Sciences, No.106, Zhongshan 2 Rd, Guangzhou, 510080, People’s Republic of China

    Ying-hua Zhao, Zai-yi Liu, Xin Chen & Chang-hong Liang

  3. Philips Healthcare, Guangzhou 18F, Tower B, CIC No.33 Zhongshan san Road, YueXiu District, Guangzhou, 510055, China

    Ying-jie Mei MS

  4. Philips Electronics Hong Kong Ltd, 6/F, Core Building 1, 1 Science Park East Avenue, Hong Kong Science Park, Shatin, New Territories, Hong Kong, China

    Queenie Chan

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  1. Ying-hua Zhao
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  2. Shao-lin Li
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Correspondence to Chang-hong Liang.

Additional information

Ying-hua Zhao and Shao-lin Li contributed equally to this article.

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Zhao, Yh., Li, Sl., Liu, Zy. et al. Detection of Active Sacroiliitis with Ankylosing Spondylitis through Intravoxel Incoherent Motion Diffusion-Weighted MR Imaging. Eur Radiol 25, 2754–2763 (2015). https://doi.org/10.1007/s00330-015-3634-2

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  • DOI: https://doi.org/10.1007/s00330-015-3634-2

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