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Publication Detail
A diffusion-based quantification technique for assessment of sacroiliitis in adolescents with enthesitis-related arthritis.
  • Publication Type:
    Journal article
  • Publication Sub Type:
  • Authors:
    Vendhan K, Bray TJ, Atkinson D, Punwani S, Fisher C, Sen D, Ioannou Y, Hall-Craggs MA
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  • Journal:
    The British Journal of Radiology
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  • Addresses:
    1 UCL Centre for Medical Imaging (Academic Radiology), 3rd floor East 250 Euston Road, London. NW1 2PG.
To investigate the use of a quantitative diffusion-weighted imaging (DWI) tool for measuring inflammation of the sacroiliac joints (SIJs) in enthesitis-related arthropathy (ERA).A retrospective study was performed with IRB approval. Subjects were adolescents who had undergone MRI of the SIJs since January 2010. Ten patients with a clinical diagnosis of ERA and ten controls with a clinical diagnosis of mechanical back pain were assessed. Axial T1W, STIR and DWI (b values 0, 50, 100, 300 and 600mm(2)/s) 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. Normalised ADC values (nADC) were defined as joint ADC divided by a reference ADC derived from normal sacral bone. Short tau inversion recovery (STIR) images were scored using a modification of an established technique (1). The correlation between nADC values and STIR scores was evaluated using Spearman's rank correlation.Mean nADC values were significantly higher in cases compared to controls (p=0.0015). There was a strong correlation between STIR scores and nADC values (R = 0.85).ADC values are significantly increased in inflamed SIJs compared to controls. There is a good correlation between this diffusion-based method and STIR scores of inflammation. Advances in knowledge: We have described and provisionally validated a method for quantifying the severity of inflammation in the SIJs in ERA using ADC measurements. This method is quick, reproducible and could potentially be automated.
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Department of Imaging
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