Feasibility of US-CT image fusion to identify the sources of abnormal vascularization in posterior sacroiliac joints of ankylosing spondylitis patients

Hu, Zhenlong; Zhu, Jiaan; Liu, Fang; Wang, Niansong; Qin, Xue

doi:10.1038/srep18356

Cited by 8 publications

(6 citation statements)

References 19 publications

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“…A few previous publications have suggested a possible role of Doppler US in determining active sacroiliitis in adults [8][9][10][11][12][13][14][15][16][17][18][19], demonstrating a high specificity of this examination, in comparison with MRI as gold standard, and proposing it as a screening method for patients with inflammatory back pain.…”

Section: Discussionmentioning

confidence: 99%

“…The US examination of SIJs was performed as described in previous papers [8][9][10][11][12][13][14][15][16][17] (Figure 1A). The probe was positioned in transverse scan over the median line of the sacrum, at the spinous apophysis of first sacral vertebra.…”

Section: Procedures and Measurementsmentioning

confidence: 99%

“…In a few studies, ultrasound (US) and Doppler US with spectral wave analysis (SWA) were used as first assessment tool to detect active sacroiliitis in adult patients [7][8][9][10][11][12][13][14][15]. More recently, Ghosh et al and Falsetti et al suggested that Power Doppler US (PDUS) with SWA may be a non-inferior diagnostic modality compared with MRI in documenting active sacroiliitis in early SpA [16,17].…”

Section: Introductionmentioning

confidence: 99%

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Doppler and Spectral Ultrasound of Sacroiliac Joints in Pediatric Patients with Suspected Juvenile Spondyloarthritis

et al. 2022

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Background: Power Doppler ultrasound (PDUS) with spectral wave analysis (SWA) has been compared with magnetic resonance imaging (MRI) in documenting active sacroiliitis in early spondyloarthritis (SpA) but, to date, PDUS/SWA has not been yet applied to the study of sacroiliac joints (SIJs) in children. Methods: A group of 20 children (13 F/7 M, mean age 14.2 y) with suspected juvenile SpA (jSpA) underwent PDUS/SWA and, subsequently, MRI of the SIJs. SIJs PDUS scoring and resistance index (RI) of the SIJs flows were recorded. The accuracy of PDUS/SWA for the diagnosis of active sacroiliitis was evaluated, with MRI as the gold standard. Results: PDUS signals were detected in 19 patients and 30 SIJs. Bone marrow edema (BME) lesions on MRI were detected in 12 patients (diagnosed as jSpA) and 22 SIJs. PDUS scoring on SIJs were higher in patients with a final diagnosis of jSpA (p = 0.003). On SWA, the mean RIs in patients with or without final diagnosis of active sacroiliitis were, respectively, 0.604 and 0.767 (p = 0.005) at joint level. A RI < 0.55 and PDUS > 1 showed the higher specificity for sacroiliitis (AUROC curve 0.854 for PDUS and 0.920 for RI). SIJs PDUS/SWA showed an overall concordance of 82.35%, with substantial agreement (k = 0.627) with MRI on the diagnosis of sacroiliitis. Conclusions: In children with sacroiliitis, PDUS demonstrates a rich vascularization into SIJs and low RIs (<0.55) have high specificity for this condition. SIJs PDUS/SWA could be useful as a screening method in children with suspected jSpA.

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Section: Discussionmentioning

confidence: 99%

Section: Procedures and Measurementsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Doppler and Spectral Ultrasound of Sacroiliac Joints in Pediatric Patients with Suspected Juvenile Spondyloarthritis

et al. 2022

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“…This study found CDUS to have an 82% sensitivity and 92% specificity for identifying abnormal flow in patients with AS [ 31 ]. US and CT can also be utilized together to improve the overall image and get a better look at where abnormal vasculature occurs in the SIJ [ 32 ]. CT provides the added benefit of providing a higher-resolution image than the US and can provide specific anatomical information on irregular blood flow in patients with AS [ 32 ].…”

Section: Reviewmentioning

confidence: 99%

Use of Multimodality Imaging in the Evaluation of Patients With Spondyloarthropathies and Sacroiliitis

Basra,

Patel,

Sobczak

et al. 2024

Cureus

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Spondyloarthropathy (SpA) is one of the most common causes of low back pain. It is caused by inflammatory arthritis in the spine, manifesting in various forms such as psoriatic arthritis (PsA), ankylosing spondylitis (AS), and sacroiliitis. A comprehensive systematic literature search was done to evaluate and compare MRI, CT, single-photon emission CT, PET, ultrasound (US) imaging, low-dose CT, and diffusion-weighted imaging (DWI) techniques in assessing SpAs. The search strategy was constructed by an analysis of key terms from relevant articles in MEDLINE ProQuest, Embase, and PubMed. The key terms used to search for these articles were “SpA,” “sacroiliitis,” “spondylitis,” “psoriatic arthritis,” “MRI,” “CT scan,” “x-ray,” “magnetic resonance imaging,” “computed tomography,” “bone density,” and “ultrasound.” A total of 1,131 articles published in English between January 1, 2003, and October 15, 2023 were identified and screened for eligibility by members of the research team, which resulted in 69 total articles selected for the final review. US has played an important role in visualizing joint inflammation and enthesitis (inflammation of the enthesis), which are common features of PsA. Although MRI and CT are considered more reliable modalities for diagnosing active sacroiliitis, US imaging with Doppler flow can also be useful in conjunction with CT images to visualize abnormal blood flow in the sacroiliac joints, as well as other joints affected by inflammatory arthritis. MRI provides increased diagnostic confidence in the diagnosis of sacroiliitis in active AS patients when compared to CT. CT is more sensitive than plain radiographs. The PET activity score showed a good correlation in diagnosing inflammatory sacroiliitis but lacked in identifying structural lesions. CT has high diagnostic accuracy, but it exposes patients to a high radiation dose. MRI visualizes joint and tissue inflammation, bone, and bone marrow change and can identify peripheral inflammation in soft tissue and joints in patients diagnosed with PsA. MRI can also visualize bone marrow changes and subchondral edema, which can aid in the early diagnosis of ankylosing SpA and gauge disease severity. DWI and short-tau inversion recovery imaging are both MRI techniques used in detecting sacroiliitis. MRI and CT are shown to be reliable imaging modalities for the diagnosis of sacroiliitis; however, it was found that Doppler US played an accurate role in the diagnosis as well. MRI visualizes joints and tissue with the most precision, making it useful in evaluating patients with PsA, while PET CT is useful in the diagnosis of inflammatory sacroiliitis patients. There is limited literature available comparing the multiple modalities of imaging available for each SpA. The review’s objective is to analyze imaging findings in patients diagnosed with sacroiliitis and SpAs. The findings in this literature review are valuable for properly assessing and diagnosing patients suffering from SpAs.

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“…This technology allows improved navigation with hand-swept imaging and has demonstrated use in a range of specialties including liver, 4,5 prostate, 6,7 and breast 8 procedures. There has also been recent interest with regard to musculoskeletal applications [9][10][11][12][13] with real-time fusion being used to guide sacroiliac injections in vitro and vivo 9,10 and guide biopsy of musculoskeletal tumors. 13 Despite this, a clear role for the technology remains yet to be established in musculoskeletal intervention.…”

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confidence: 99%

The Potential Use of Ultrasound-Magnetic Resonance Imaging Fusion Applications in Musculoskeletal Intervention

2016

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We sought to assess the potential use of an application allowing real-time ultrasound spatial registration with previously acquired magnetic resonance imaging in musculoskeletal procedures. The ultrasound fusion application was used to perform a range of outpatient procedures including piriformis, sacroiliac joint, pudendal and intercostal nerve perineurial injections, hamstring-origin calcific tendonopathy barbotage, and 2 soft tissue biopsies at our institution in 2015. The application was used in a total of 7 procedures in 7 patients, all of which were technically successful. The ages of patients ranged from 19 to 86 years. Particular use of the fusion application compared to sonography alone was noted in the biopsy of certain soft tissue lesions and in perineurial therapeutic injections.

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Feasibility of US-CT image fusion to identify the sources of abnormal vascularization in posterior sacroiliac joints of ankylosing spondylitis patients

Cited by 8 publications

References 19 publications

Doppler and Spectral Ultrasound of Sacroiliac Joints in Pediatric Patients with Suspected Juvenile Spondyloarthritis

Doppler and Spectral Ultrasound of Sacroiliac Joints in Pediatric Patients with Suspected Juvenile Spondyloarthritis

Use of Multimodality Imaging in the Evaluation of Patients With Spondyloarthropathies and Sacroiliitis

The Potential Use of Ultrasound-Magnetic Resonance Imaging Fusion Applications in Musculoskeletal Intervention

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