Baskent University, Faculty of Medicine, Department of Radiology, Turkey.
Eur J Radiol. 2013 Dec;82(12):2316-21. doi: 10.1016/j.ejrad.2013.08.032. Epub 2013 Aug 30.
Sacroiliitis is one of the diagnostic criteria of seronegative SpA. The purpose of our study is to show the signal characteristics of the sacral and iliac surfaces by DWI which may contribute in early diagnosis of sacroiliitis and investigate the correlation between ADC values and clinical and laboratory parameters.
62 patients with inflammatory low back pain, with a history or suspect of seronegative SpA are enrolled into the study. 40 age and sex-matched subjects without SpA constituted the control group. After obtaining routine T1 and T2 weighted sequences, echo planar imaging at b values of 0, 400 and 800 was performed. ADC values on both surfaces of the both sacroiliac joints were measured in all subjects. The CRP and sedimentation results and the presence of arthritis and enthesitis were also correlated with the ADC values.
ADC values on both surfaces of the both sacroiliac joints were found 0.23 × 10(-3)mm(2)/sn in the control group. In the patient group, mean ADC value of 0.48 × 10(-3)mm(2)/sn was obtained (p<0.001), which was statistically significant, compatible with the increased diffusion due to medullary edema in early sacroiliitis. There was a slight correlation between CRP and ADC values; presumed to be showing the relation between the activity of the disease and the active inflammation on DWI. There was no correlation between arthritis and enthesitis and the ADC values (p>0.001).
DWI, by measuring ADC values, adds significant information in the early diagnosis of sacroiliitis and may help to evaluate the efficiency of the treatment.
骶髂关节炎是血清阴性脊柱关节病的诊断标准之一。本研究的目的是通过 DWI 显示骶髂关节表面的信号特征，这可能有助于早期诊断骶髂关节炎，并探讨 ADC 值与临床和实验室参数之间的相关性。
本研究纳入了 62 例有炎症性下腰痛病史或疑诊血清阴性脊柱关节病的患者。40 名年龄和性别匹配的无脊柱关节病的受试者构成对照组。在获得常规 T1 和 T2 加权序列后，对 b 值为 0、400 和 800 的平面回波成像进行了检查。在所有受试者中测量了双侧骶髂关节表面的 ADC 值。还将 CRP 和沉降率结果以及关节炎和肌腱炎的存在与 ADC 值相关联。
对照组双侧骶髂关节表面的 ADC 值为 0.23×10(-3)mm(2)/sn。在患者组中，获得了 0.48×10(-3)mm(2)/sn 的平均 ADC 值（p<0.001），这具有统计学意义，与早期骶髂关节炎骨髓水肿引起的扩散增加相符。CRP 和 ADC 值之间存在轻微相关性；被认为是显示疾病活动与 DWI 上活跃炎症之间的关系。关节炎和肌腱炎与 ADC 值之间无相关性（p>0.001）。
DWI 通过测量 ADC 值，为早期诊断骶髂关节炎提供了重要信息，并可能有助于评估治疗效果。
