A diffusion-based quantification technique for assessment of sacroiliitis in adolescents with enthesitis-related arthritis

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Abstract

Objective: To investigate the use of a quantitative diffusion-weighted imaging (DWI) tool for measuring inflammation of the sacroiliac joints (SIJs) in enthesitisrelated arthritis (ERA). Methods: A retrospective study was performed with institutional review board approval. Subjects were adolescents who had undergone MRI of the SIJs since January 2010. 10 patients with a clinical diagnosis of ERA and 10 controls with a clinical diagnosis of mechanical back pain were assessed. Axial T1 weighted, short tau inversion recovery (STIR) and DWI (b-values 0, 50, 100, 300 and 600mm2 s21) images were acquired. Apparent diffusion coefficient (ADC) maps were generated using a monoexponential fit. On each of four slices, two to three linear regions-of-interest were placed on each joint. Normalized ADC (nADC) values were defined as joint ADC divided by a reference ADC derived from normal sacral bone. STIR images were scored using a modification of an established technique. The correlation between nADC values and STIR scores was evaluated using Spearman's rank correlation. Results: Mean nADC values were significantly higher in cases than in controls (p50.0015). There was a strong correlation between STIR scores and nADC values (R50.85). Conclusion: ADC values are significantly increased in inflamed SIJs compared with controls. There is a good correlation between this diffusion-based method and STIR scores of inflammation.

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Vendhan, K., Bray, T. J. P., Atkinson, D., Punwani, S., Fisher, C., Sen, D., … Hall-Craggs, M. A. (2016). A diffusion-based quantification technique for assessment of sacroiliitis in adolescents with enthesitis-related arthritis. British Journal of Radiology, 89(1059). https://doi.org/10.1259/bjr.20150775

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