Ghosh Alakendu, Mondal Sumantro, Sinha Debanjali, Nag Arijit, Chakraborty Sumit
Department of Rheumatology, Department of General Medicine and Department of Radiology, Institute of Post Graduate Medical Education and Research, Kolkata, West Bengal, India. Department of Rheumatology, Department of General Medicine and Department of Radiology, Institute of Post Graduate Medical Education and Research, Kolkata, West Bengal, India.
Department of Rheumatology, Department of General Medicine and Department of Radiology, Institute of Post Graduate Medical Education and Research, Kolkata, West Bengal, India.
Rheumatology (Oxford). 2014 Nov;53(11):2030-4. doi: 10.1093/rheumatology/keu220. Epub 2014 Jun 9.
The aims of this study were to identify and characterize features of sacroiliitis in patients with non-radiographic inflammatory low back pain by ultrasonography (USG) and to correlate the findings with that of MRI.
MRI and USG of SI joints were performed on 29 patients who fulfilled the definition of inflammatory low back pain according to the Assessment of SpondyloArthritis International Society 2009 criteria for axial SpA but were X-ray negative for sacroiliitis. Increased vascularity, low resistive index (RI) and hyperechogenicity of the joint space were considered USG features of sacroiliitis. The findings were compared with those of 32 controls. USG features of sacroiliitis were compared with MRI by κ statistics.
Receiver operating characteristic analysis revealed cut-off values for flow signals and RI of 3 and 0.605, respectively. There was a significant difference in the number of flow signals, RI and echogenicity of the SI joint between MRI-proven cases and controls. The Cohen's κ for flow signals, RI and hyperechogenicity when compared with MRI were 0.816 (95% CI 0.676, 0.937) and 0.821 (95% CI 0.662, 0.965) and 0.403 (95% CI 0.108, 0.695). Taking both flow signals and RI parameters as criteria for determining sacroiliitis, comparison with MRI returned a κ of 0.816 (95% CI 0.601, 0.963).
Three or more flow signals and a RI ≤0.605 can be applied as USG criteria for sacroiliitis. USG can be a cost-effective and non-inferior modality compared with MRI in documenting sacroiliitis in early SpA.
本研究旨在通过超声检查（USG）识别和描述非放射学炎症性下背痛患者骶髂关节炎的特征，并将这些发现与磁共振成像（MRI）的结果进行关联。
对29例符合2009年国际脊柱关节炎评估协会轴向SpA标准中炎症性下背痛定义但骶髂关节炎X线检查为阴性的患者进行骶髂关节的MRI和USG检查。血管增多、低阻力指数（RI）和关节间隙高回声被视为骶髂关节炎的USG特征。将结果与32名对照组进行比较。通过κ统计将骶髂关节炎的USG特征与MRI结果进行比较。
受试者工作特征分析显示，血流信号和RI的截断值分别为3和0.605。MRI确诊病例与对照组之间骶髂关节血流信号数量、RI和回声性存在显著差异。与MRI相比，血流信号、RI和高回声性的Cohen's κ分别为0.816（95%CI 0.676, 0.937）、0.821（95%CI 0.662, 0.965）和0.403（95%CI 0.108, 0.695）。以血流信号和RI参数作为确定骶髂关节炎的标准，与MRI比较得出κ为0.816（95%CI 0.601, 0.963）。
三个或更多血流信号和RI≤0.605可作为骶髂关节炎的USG标准。在记录早期SpA中的骶髂关节炎方面，与MRI相比，USG可能是一种经济有效的且非劣效的检查方式。
