Kim Beum Jin, Lee Young Han, Lee Joohee, Kim Sungjun, Song Ho-Taek
Department of Radiology, Research Institute of Radiological Science, Center for Clinical Imaging Data Science (CCIDS), Yonsei University College of Medicine, Seoul 03722, Republic of Korea.
Diagnostics (Basel). 2022 Nov 17;12(11):2842. doi: 10.3390/diagnostics12112842.
Objectives: Ankylosing spondylitis (AS) is a chronic inflammatory arthritis with characteristic involvement of the spine and sacroiliac joints. MRI may be the only indicator of disease activity or response. This study aimed to use a novel water fraction measurement technique on MRI as a biomarker to predict disease activity in patients with AS. Methods: We enrolled 39 patients (18 men [mean age, 38.6 years; range, 18−59 years] and 21 women [mean age, 39.3 years; range, 23−61 years]) who were clinically diagnosed with AS and underwent MRI, including mDixon sequences. Water fraction values of sacroiliac joint subchondral bone marrow were derived from the mDixon sequences. The Ankylosing Spondylitis Disease Activity Score (ASDAS) was recorded using clinical information and laboratory values from medical records. Multiple linear regression, Firth logistic regression, and intraclass correlation coefficients were used for the statistical analysis. Results: In multiple linear regression, water fraction, subchondral bone marrow edema, subchondral bone erosion, and subchondral bone marrow enhancements were significantly associated with ASDAS with C-reactive protein (ASDAS-CRP). The water fraction parameters showed a good linear correlation with ASDAS-CRP and ASDAS with erythrocyte sedimentation rate (ASDAS-ESR) (beta coefficient = 1.98, p < 0.001 and beta coefficient = 1.60, p = 0.003). Firth logistic regression showed that water fraction was a significant predictor of ASDAS-CRP but not ASDAS-ESR. The intraclass correlation coefficient showed excellent repeatability for the three repeated measures of the water fraction. Conclusion: Water fraction parameter could be a good imaging biomarker of disease activity status. The sacroiliac joint evaluated by mDixon MRI may be a promising biomarker of disease progression in patients with spondyloarthritis.
强直性脊柱炎（AS）是一种慢性炎症性关节炎，其特征是脊柱和骶髂关节受累。磁共振成像（MRI）可能是疾病活动或反应的唯一指标。本研究旨在利用MRI上一种新型的水分数测量技术作为生物标志物来预测AS患者的疾病活动。方法：我们纳入了39例临床诊断为AS并接受MRI检查（包括mDixon序列）的患者（18例男性[平均年龄38.6岁；范围18 - 59岁]和21例女性[平均年龄39.3岁；范围23 - 61岁]）。骶髂关节软骨下骨髓的水分数值来自mDixon序列。使用病历中的临床信息和实验室值记录强直性脊柱炎疾病活动评分（ASDAS）。采用多元线性回归、Firth逻辑回归和组内相关系数进行统计分析。结果：在多元线性回归中，水分数、软骨下骨髓水肿、软骨下骨侵蚀和软骨下骨髓强化与C反应蛋白相关的ASDAS（ASDAS-CRP）显著相关。水分数参数与ASDAS-CRP以及红细胞沉降率相关的ASDAS（ASDAS-ESR）显示出良好的线性相关性（β系数 = 1.98，p < 0.001和β系数 = 1.60，p = 0.003）。Firth逻辑回归显示水分数是ASDAS-CRP的显著预测因子，但不是ASDAS-ESR的预测因子。组内相关系数显示水分数的三次重复测量具有出色的可重复性。结论：水分数参数可能是疾病活动状态的良好影像学生物标志物。通过mDixon MRI评估的骶髂关节可能是脊柱关节炎患者疾病进展的有前景的生物标志物。
