Assessment of active and inactive sacroiliitis in patients with ankylosing spondylitis using quantitative dynamic contrast-enhanced MRI

Abstract

2 Technical Efficacy: Stage 2 J. MAGN. RESON. IMAGING 2017;46:71-78.

Quantitative DCE-MRI: An Efficient Diagnostic Technique for Evaluating Early Micro-environment Permeability Changes in Ankylosing Spondylitis

“…This was attributed to in ltration of the in ammatory cells and pannus formation in the synovial area with increased microcirculation and greater capillary permeability. This result was consistent with that of Zhang et al [3] who found that K trans , K ep and V e of AS patients in the active group were signi cantly higher than those of AS patients in the inactive group patients using quantitative DCE-MRI.These results revealed that quantitative DCE-MRI parameters could differentiate between active and inactive AS.Higher K trans and K ep values are associated with increased microcirculation and greater capillary permeability of in ammatory tissues in the active sacroiliitis.Another previous study [23] has shown DCE-MRI parameters of the K trans ,k ep , and V e could be used to detect synovial in ammation in patients with early arthritis and correlated with synovial expression of the endothelial cell (EC) marker von Willebrand factor (vWF) ,which could facilitate the evaluation of joints inaccessible to next proper clinical examination.Our result was similar to the above report that quantitative DCE-MRI can provide performance for detecting early in ammation micro-environment permeability in SIJ of AS. In addition, there was a statistically signi cant positive correlation between the K trans , K ep ,V e with increasing weeks and changes in the K trans occurred earlier than K ep and V e .Based on our results,the K trans was more sensitive than the other parameters and it may has a potentially e cacy to predict early in ammatory activity more timely.…”

“…Diagnosis of AS often depends on the clinical symptoms and imaging abnormities. Sacroiliitis is the most important clinical manifestation of AS [3] .However,there is high variability in clinical diagnosis and scoring systems that are mostly subjective. Evaluating active progression of AS by magnetic resonance imaging (MRI) had been widely accepted,which is a sensitive, non-invasive method that can permit the visualization of active and structural lesions,even in the absence of radiographically evident disease [4][5][6][7][8][9] .However,the DCE-MRI performance in AS simply used signal intensity changes over time to assess in ammation changes in the SIJ still remained subjective,limited by the inability to provide objective quantitative parameters,which was suggested as an imaging biomarker that is sensitive to disease progression.…”

“…In recent years,quantitative dynamic contrast enhanced magnetic resonance imaging(DCE-MRI),basing on a pharmacokinetic model,have been successfully used to assess changes in different diseases [3,[10][11][12] .It can provide su cient information on microenvironment changes or quantitatively evaluate certain in ammation processes that re ect the intrinsic properties of tissues [13] .In the management of early in ammatory AS joint, there is also a need for reliable noninvasive quantitative methods to closely monitor synovial in ammation to predict early diagnosis.As such,the interrelationship between early longitudinal pathologic changes of AS with quantitative MRI parameters should be focused on.…”

Quantitative Imaging in Inflammatory Arthritis: Between Tradition and Innovation

“…66 For patients with AS, DCE-MRI was shown to be a robust method to evaluate active disease and treatment efficacy in bones and entheses. 6,67 Thus, according to the reported evidence, the contribution of this technique in the diagnostic and therapeutic management of various inflammatory rheumatic diseases, and especially of RA, is already well known. As noted by the OMERACT group, regarding this latter disease, DCE-MRI may even replace the semiquantitative Rheumatoid Arthritis Magnetic Resonance Imaging Score (RAMRIS score) in the future.…”

Clinical applications of advanced magnetic resonance imaging techniques for arthritis evaluation

“…Post contrast fat suppression T1-weighted images as well as DCE-MRI have demonstrated its usefulness for SI detection with higher accuracy of the latter for detection of active disease even in the earliest phases[ 49 ].…”