Araştırma Makalesi
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The Role of Diffusion Weighted MRI in Diagnosis of Sacroiliitis

Yıl 2023, Cilt: 20 Sayı: 3, 631 - 636, 31.12.2023
https://doi.org/10.35440/hutfd.1375927

Öz

Background: The main aim of this study is to investigate the effectiveness of Apparent Diffusion Coefficient (ADC) and Diffusion Weighted Imaging (DWI) in identifying and detecting active sacro-iliitis. The study seeks to evaluate the potential of these imaging techniques as diagnostic tools for this particular condition.
Materials and Methods: A total of 79 people underwent MRI examination for low back pain. Thirty-four of these individuals did not show any pathology in the sacroiliac joints and were included in the control group. 45 people diagnosed with sacroiliitis formed the patient group. All participants underwent spin echo, planar echo, diffusion-weighted MR imaging at a b=1000 s/mm². ADC values were determined by assessing the subchondral regions adjacent to both sacroiliac joints. Relative ADC values were obtained for both the patient and control groups.
Results: The study found a significant difference (p<0.05) in mean ADC values between the pa-tient group (1202.4±268.2 mm²/s) and the control group (423.9±71.9 mm²/s). These results indicate distinct diffusion patterns between the two groups. Additionally, the relative ADC values were significantly different (p<0.05) with 0.434 in the patient group and 0.153 in the control group, further supporting the observed disparities in diffusion characteristics.
Conclusions: Diffusion-weighted imaging has similar diagnostic efficacy to other MRI methods in detecting active sacroiliitis. In addition, it is thought that the relative ADC values may contribute more to the diagnosis of sacroiliitis.

Kaynakça

  • 1. Althoff CE, Feist E, Burova E, Eshed I, Bollow M, Hamm B, et al. Magnetic resonance imaging of active sacroiliitis: do we really need gadolinium? Eur J Radiol. 2009;71(2):232–6.
  • 2. Gezmis E, Donmez FY, Agildere M. Diagnosis of early sacroiliitis in seronegative spondyloarthropathies by DWI and correlation of clinical and laboratory findings with ADC values. Eur J Radiol. 2013;82(12):2316–21.
  • 3. Braun J, Bollow M, Remlinger G, Eggens U, Rudwaleit M, Distler A, Sieper J. Prevalence of spondylarthropathies in HLA-B27 positive and negative blood donors. Arthritis Rheum. 1998;41(1):58-67.
  • 4. Akdeniz H, Avcu S, Ünal Ö, Bora A, Karahocagil MK. The value of diffusion-weighted imaging in the diagnosis of active sacroiliitis. Eastern Journal of Medicine. 2019;24(1):30–7.
  • 5. Tsuruda JS, Chew WM, Moseley ME, Norman D. Diffusion-weighted MR imaging of the brain: value of differentiat-ing between extraaxial cysts and epidermoid tumors. AJR Am J Roentgenol. 1990;155(5):1059-65.
  • 6. Chien D, Kwong KK, Gress DR, Buonanno FS, Buxton RB, Rosen BR. MR diffusion imaging of cerebral infarction in humans. AJNR Am J Neuroradiol. 1992 Jul-Aug;13(4):1097-102.
  • 7. Park SO, Kim JK, Kim KA, Park BW, Kim N, Cho G, et al. Relative apparent diffusion coefficient: determination of reference site and validation of benefit for detecting met-astatic lymph nodes in uterine cervical cancer. J Magn Re-son Imaging. 2009;29(2):383–90.
  • 8. Proft F, Poddubnyy D. Ankylosing spondylitis and axial spondyloarthritis: recent insights and impact of new clas-sification criteria. Ther Adv Musculoskelet Dis. 2018;10(5–6):129–39.
  • 9. Tsoi C, Griffith JF, Lee RKL, Wong PCH, Tam LS. Imaging of sacroiliitis: Current status, limitations and pitfalls. Quant Imaging Med Surg. 2019;9(2):318–35.
  • 10. Pipikos T, Kassimos D, Angelidis G, Koutsikos J. Bone Single Photon Emission/Computed Tomography in the De-tection of Sacroiliitis in Seronegative Spondyloarthritis: A Comparison with Magnetic Resonance Imaging. Mol Im-aging Radionucl Ther. 2017 Oct 3;26(3):101-109.
  • 11. Lorenzin M, Ortolan A, Felicetti M, Vio S, Favero M, Polito P, et al. Spine and Sacroiliac Joints Lesions on Magnetic Resonance Imaging in Early Axial-Spondyloarthritis During 24-Months Follow-Up (Italian Arm of SPACE Study). Front Immunol. 2020;11:521138.
  • 12. Melchior J, Azraq Y, Chary-Valckenaere I, Rat AC, Texeira P, Blum A, et al. Radiography and abdominal CT compared with sacroiliac joint CT in the diagnosis of sacroiliitis. Acta radiol. 2017;58(10):1252–9.
  • 13. Tasar S, Ciraci S, Diydem Yilmaz P, Oysu AS, Bukte Y, Sozeri B. Efficacy of diffusion weighted imaging in sacroil-iac joint MRI in children. North Clin Istanb. 2023;10(2):131–8.
  • 14. Ranga A, Agarwal Y, Meena V, Chopra R. Comparison of radiography, computed tomography and magnetic reso-nance imaging in the detection of sacroiliitis in ankylosing spondylitis. Astrocyte 2016 Oct 1;2(4):179–179.
  • 15. Çelikyay F, Öner Y, Talı T, Roux P Le, Deveci Ş, Yüksekkaya R. Vertebral Metastaz, Dejenerasyon ve Spondilodiskit-lerin Ayırıcı Tanısında Non-CPMG SS-FSE Difüzyon Ağırlıklı MR Görüntülemenin Katkısının Değerlendirilmesi. Fırat Tıp Dergisi 2014;19(2):64-71.
  • 16. Wang D, Yin H, Liu W, Li Z, Ren J, Wang K, et al. Compara-tive analysis of the diagnostic values of T2 mapping and diffusion-weighted imaging for sacroiliitis in ankylosing spondylitis. Skeletal Radiol. 2020;49(10):1597–606.
  • 17. Toslak İE, Bilgilisoy Filiz M, Çekiç B, Parlak AE, Çay HF, Yildiz S, et al. Application of Diffusion-Weighted Imaging in the Detection of Active Sacroiliitis and the Comparison of Apparent Diffusion Coefficient and Relative Apparent Diffusion Coefficient Values. Arch Rheumatol. 2016;31(3):254–64.

Difüzyon Ağırlıklı MRG'nin Sakroiliit Tanısındaki Rolü

Yıl 2023, Cilt: 20 Sayı: 3, 631 - 636, 31.12.2023
https://doi.org/10.35440/hutfd.1375927

Öz

Amaç: Bu çalışmanın temel amacı, Görünür Difüzyon Katsayısı (ADC) ve Difüzyon Ağırlıklı Görüntüleme'nin (DWI) aktif sakroiletin tanımlanması ve saptanmasındaki etkinliğini araştırmaktır. Çalışma, bu görüntüleme tekniklerinin bu özel durum için teşhis aracı olarak potansiyelini değerlendirmeyi amaçlamaktadır.
Materyel ve metod: Toplam 79 kişiye bel ağrısı nedeniyle MR incelemesi yapıldı. Bu bireylerden 34'ü sakroiliak eklemlerde herhangi bir patoloji göstermeyerek kontrol grubuna dahil edildi. Hasta grubunu sakroileit tanısı alan 45 kişi oluşturdu. Tüm katılımcılara b=1000 s/mm²'de spin eko, düzlemsel eko, difüzyon ağırlıklı MR görüntüleme uygulandı. ADC değerleri her iki sakroiliak ekleme komşu subkondral bölgeler değerlendirilerek belirlendi. Hem hasta hem de kontrol grubu için rölatif ADC değerleri elde edildi.
Bulgular: Çalışmada hasta grubu (1202,4±268,2 mm²/s) ile kontrol grubu (423,9±71,9 mm²/s) arasında ortalama ADC değerleri açısından anlamlı bir fark (p<0,05) bulundu. Bu sonuçlar iki grup arasındaki farklı difüzyon modellerini göstermektedir. Ek olarak, göreceli ADC değerleri hasta grubunda 0,434 ve kontrol grubunda 0,153 ile anlamlı derecede farklıydı (p<0,05), bu da difüzyon özelliklerinde gözlenen eşitsizlikleri desteklemektedir.
Sonuç: Difüzyon ağırlıklı görüntülemenin aktif sakroiletin saptanmasında diğer MRG yöntemleriyle benzer tanısal etkinliği vardır. Ayrıca göreceli ADC değerlerinin sakroileit tanısına daha fazla katkı sağlayabileceği düşünülmektedir

Etik Beyan

çALIŞMAMIZ hELSİKİ BİLDİRGESİNE UYUMLU OLARAK YÜRÜTÜLMÜŞ OLUP HARRAN ÜNİVERSİTESİ ETİK KURULU TARAFINDAN ONAYLANMIŞTIR.

Kaynakça

  • 1. Althoff CE, Feist E, Burova E, Eshed I, Bollow M, Hamm B, et al. Magnetic resonance imaging of active sacroiliitis: do we really need gadolinium? Eur J Radiol. 2009;71(2):232–6.
  • 2. Gezmis E, Donmez FY, Agildere M. Diagnosis of early sacroiliitis in seronegative spondyloarthropathies by DWI and correlation of clinical and laboratory findings with ADC values. Eur J Radiol. 2013;82(12):2316–21.
  • 3. Braun J, Bollow M, Remlinger G, Eggens U, Rudwaleit M, Distler A, Sieper J. Prevalence of spondylarthropathies in HLA-B27 positive and negative blood donors. Arthritis Rheum. 1998;41(1):58-67.
  • 4. Akdeniz H, Avcu S, Ünal Ö, Bora A, Karahocagil MK. The value of diffusion-weighted imaging in the diagnosis of active sacroiliitis. Eastern Journal of Medicine. 2019;24(1):30–7.
  • 5. Tsuruda JS, Chew WM, Moseley ME, Norman D. Diffusion-weighted MR imaging of the brain: value of differentiat-ing between extraaxial cysts and epidermoid tumors. AJR Am J Roentgenol. 1990;155(5):1059-65.
  • 6. Chien D, Kwong KK, Gress DR, Buonanno FS, Buxton RB, Rosen BR. MR diffusion imaging of cerebral infarction in humans. AJNR Am J Neuroradiol. 1992 Jul-Aug;13(4):1097-102.
  • 7. Park SO, Kim JK, Kim KA, Park BW, Kim N, Cho G, et al. Relative apparent diffusion coefficient: determination of reference site and validation of benefit for detecting met-astatic lymph nodes in uterine cervical cancer. J Magn Re-son Imaging. 2009;29(2):383–90.
  • 8. Proft F, Poddubnyy D. Ankylosing spondylitis and axial spondyloarthritis: recent insights and impact of new clas-sification criteria. Ther Adv Musculoskelet Dis. 2018;10(5–6):129–39.
  • 9. Tsoi C, Griffith JF, Lee RKL, Wong PCH, Tam LS. Imaging of sacroiliitis: Current status, limitations and pitfalls. Quant Imaging Med Surg. 2019;9(2):318–35.
  • 10. Pipikos T, Kassimos D, Angelidis G, Koutsikos J. Bone Single Photon Emission/Computed Tomography in the De-tection of Sacroiliitis in Seronegative Spondyloarthritis: A Comparison with Magnetic Resonance Imaging. Mol Im-aging Radionucl Ther. 2017 Oct 3;26(3):101-109.
  • 11. Lorenzin M, Ortolan A, Felicetti M, Vio S, Favero M, Polito P, et al. Spine and Sacroiliac Joints Lesions on Magnetic Resonance Imaging in Early Axial-Spondyloarthritis During 24-Months Follow-Up (Italian Arm of SPACE Study). Front Immunol. 2020;11:521138.
  • 12. Melchior J, Azraq Y, Chary-Valckenaere I, Rat AC, Texeira P, Blum A, et al. Radiography and abdominal CT compared with sacroiliac joint CT in the diagnosis of sacroiliitis. Acta radiol. 2017;58(10):1252–9.
  • 13. Tasar S, Ciraci S, Diydem Yilmaz P, Oysu AS, Bukte Y, Sozeri B. Efficacy of diffusion weighted imaging in sacroil-iac joint MRI in children. North Clin Istanb. 2023;10(2):131–8.
  • 14. Ranga A, Agarwal Y, Meena V, Chopra R. Comparison of radiography, computed tomography and magnetic reso-nance imaging in the detection of sacroiliitis in ankylosing spondylitis. Astrocyte 2016 Oct 1;2(4):179–179.
  • 15. Çelikyay F, Öner Y, Talı T, Roux P Le, Deveci Ş, Yüksekkaya R. Vertebral Metastaz, Dejenerasyon ve Spondilodiskit-lerin Ayırıcı Tanısında Non-CPMG SS-FSE Difüzyon Ağırlıklı MR Görüntülemenin Katkısının Değerlendirilmesi. Fırat Tıp Dergisi 2014;19(2):64-71.
  • 16. Wang D, Yin H, Liu W, Li Z, Ren J, Wang K, et al. Compara-tive analysis of the diagnostic values of T2 mapping and diffusion-weighted imaging for sacroiliitis in ankylosing spondylitis. Skeletal Radiol. 2020;49(10):1597–606.
  • 17. Toslak İE, Bilgilisoy Filiz M, Çekiç B, Parlak AE, Çay HF, Yildiz S, et al. Application of Diffusion-Weighted Imaging in the Detection of Active Sacroiliitis and the Comparison of Apparent Diffusion Coefficient and Relative Apparent Diffusion Coefficient Values. Arch Rheumatol. 2016;31(3):254–64.
Toplam 17 adet kaynakça vardır.

Ayrıntılar

Birincil Dil İngilizce
Konular Radyoloji ve Organ Görüntüleme
Bölüm Araştırma Makalesi
Yazarlar

Mehmet Demir 0000-0002-5031-6324

Erdem Dağlıoğlu 0009-0007-1489-0111

Fatma Nurefşan Boyacı 0000-0002-8215-4227

Cihad Varol 0000-0003-4639-6066

Bahadır Duman 0000-0001-9244-9224

Erken Görünüm Tarihi 22 Aralık 2023
Yayımlanma Tarihi 31 Aralık 2023
Gönderilme Tarihi 18 Ekim 2023
Kabul Tarihi 18 Aralık 2023
Yayımlandığı Sayı Yıl 2023 Cilt: 20 Sayı: 3

Kaynak Göster

Vancouver Demir M, Dağlıoğlu E, Boyacı FN, Varol C, Duman B. The Role of Diffusion Weighted MRI in Diagnosis of Sacroiliitis. Harran Üniversitesi Tıp Fakültesi Dergisi. 2023;20(3):631-6.

Harran Üniversitesi Tıp Fakültesi Dergisi  / Journal of Harran University Medical Faculty