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• Clinical Article •
The value of diffusion kurtosis imaging in the inflammatory activity evaluation of sacroiliac joints lesions in ankylosing spondylitis
ZUO Hou-dong  ZHANG Xiao-ming  JING Zong-lin  YAO Wei-wu 

DOI:10.12015/issn.1674-8034.2018.06.006.


[Abstract] Objective: To investigate the value of diffusion kurtosis imaging (DKI) in evaluating the sacroiliac joints inflammatory activity with ankylosing spondylitis (AS).Materials and Methods: 31 cases were enrolled in accordance with ankylosing spondylitis diagnostic criteria, including 21 men and 10 women. Active and stable AS groups were divided according to clinical biochemical indexes, including erythrocyte sedimentation rate (ESR), C-reactive protein (CRP) and Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) grade. All the cases were performed on MRI with T2-weighted imaging (T2WI) and DKI sequences. The imaging features of the involved sacroiliac joints were observed on T2WI. On MRI, the Spondyloarthritis Research Consortium of Canada (SPARCC) grade was calculated. Then the correlation of SPARCC and BASDAI grade was analyzed. The mean kurtosis (MK), mean diffusivity (MD) and apparent diffusion coefficient (ADC) values were measured and analyzed with statistical software.Results: All the bilateral sacroiliac joints with 31 cases were involved. The various degree of bone marrow edema under the joint surface were observed. Articular surface bone absorption and cystic lesions were showed on 8 and 2 cases respectively. The bone marrow edema displayed hyperintensity and slight hyperintensity on T2WI, DKI and DKI-ADC maps. Strong correlation was obtained between SPARCC and BASDAI grades (P<0.05). The MK, MD and ADC values of stable group were 1.03±0.05, (1.37±0.04)×10-3 mm2/s and (0.98±0.18)×10-3 mm2/s respectively, and 0.89±0.03, (1.4±0.04)×10-3 mm2/s and (1.32±0.18)×10-3 mm2/s for active group. The MK and ADC values between of active and stable groups had significant statistical difference (P<0.05), while MD values had no statistical difference (P>0.05).Conclusions: DKI can serve as an effective tool for AS activity evaluation. MK and ADC values can provide useful information for AS diagnosis, differential diagnosis and therapeutic effect of monitoring and can be the potential imaging biomarkers.
[Keywords] Spondylitis, ankylosing；Magnetic resonance imaging；Diffusion kurtosis imaging；Sacroiliitis

ZUO Hou-dong Sichuan Key Laboratory of Medical Imaging, Department of Radiology, Affiliated Hospital of North Sichuan Medical College, Nanchong 637000, China

ZHANG Xiao-ming Sichuan Key Laboratory of Medical Imaging, Department of Radiology, Affiliated Hospital of North Sichuan Medical College, Nanchong 637000, China

JING Zong-lin Sichuan Key Laboratory of Medical Imaging, Department of Radiology, Affiliated Hospital of North Sichuan Medical College, Nanchong 637000, China

YAO Wei-wu* Department of Radiology, Shanghai Jiaotong University Affiliated Sixth People’s Hospital, Shanghai 200233, China

*Correspondence to: Yao WW, E-mail: yaoweiwu@yahoo.com

Conflicts of interest   None.

ACKNOWLEDGMENTS  This work was part of Natural Science Foundation of China No.81701756
Received  2018-03-08
Accepted  2018-04-28
DOI: 10.12015/issn.1674-8034.2018.06.006
DOI:10.12015/issn.1674-8034.2018.06.006.

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