Detection of synovial inflammation in the sacroiliac joint space through intravoxel incoherent motion imaging: an alternative to contrast agents.

IF 1.4 4区 医学 Q3 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING
Murat Ağırlar, Barış Genç, Aysu Başak Özbalcı
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引用次数: 0

Abstract

Purpose: We investigated the diagnostic accuracy of simplified intravoxel incoherent motion (IVIM) imaging for detecting synovial inflammation in the sacroiliac joint (SIJ) in a population with active sacroiliitis.

Methods: In accordance with the Assessment of Spondyloarthritis International Society criteria, 86 SIJs of 46 patients with active sacroiliitis were included in this retrospective study conducted between November 2020 and January 2022. Based on T1-weighted post-gadolinium images, the SIJs were divided into two groups: synovial inflammation positive (SIP) (n = 28) and synovial inflammation negative (SIN) (n = 58). Synovial areas in the SIJ space were independently and blindly reviewed for the presence of inflammation by two radiologists with differing levels of expertise in radiology. Using four b values, apparent diffusion coefficient (ADC)= ADC (0, 800) and the simplified 3T IVIM method parameters true diffusion coefficient (D1)= ADC (50, 800), D= ADC (400, 800), f1= f (0, 50, 800), f2= f (0, 400, 800), pseudodiffusion coefficient (D*)= D* (0, 50, 400, 800), ADClow = ADC (0, 50), and ADCdiff= ADClow - D were generated voxel by voxel for each patient. The IVIM and ADC parameters at the SIN and SIP joints were compared.

Results: The D parameter was significantly increased in SIP areas (1.23 ± 0.34 × 10-3 mm2/s) compared with SIN areas (1.02 ± 0.16 × 10-3 mm2/s) (P = 0.004). Conversely, the D* parameter was significantly decreased in SIP areas (21.78 ± 3.77 × 10-3 mm2/s) compared with SIN areas (16.19 ± 4.58 × 10-3 mm2/s) (P < 0.001). When the optimal cut-off value of 1.11 × 10-3 mm2/s was selected, the sensitivity for the D value was 71% and the specificity was 72% [area under the curve (AUC): 0.716)]. When the optimal cut-off value of 21.06 × 10-3 mm2/s was selected, the sensitivity for the D* value was 78.6%, and the specificity was 79.3% (AUC: 0.829). The interclass correlation coefficient was excellent for f1, f2 D*, D, and ADCdiff, good for ADClow and D1, but reasonable for ADC.

Conclusion: The presence of synovial inflammation in the SIJ can be evaluated with high sensitivity and specificity using only four b values through the simplified IVIM method without the need for a contrast agent.

Clinical significance: IVIM imaging is a technique that allows us to gain insights into tissue perfusion without the administration of contrast agents, utilizing diffusion-weighted images. In this study, for the first time, we demonstrated the potential of detecting synovial inflammation in the SIJ using IVIM, specifically through the pseudodiffusion (D*) parameter, without the need for contrast agents.

通过体外非相干运动成像检测骶髂关节间隙的滑膜炎症:造影剂的替代品。
目的:我们研究了简化体素内非相干运动(IVIM)成像在活动性骶髂关节炎人群中检测骶髂关节(SIJ)滑膜炎症的诊断准确性:根据脊柱关节炎国际协会的评估标准,这项于2020年11月至2022年1月进行的回顾性研究纳入了46名活动性骶髂关节炎患者的86个骶髂关节。根据 T1 加权钆后图像,SIJ 被分为两组:滑膜炎症阳性组(SIP)(28 人)和滑膜炎症阴性组(SIN)(58 人)。SIJ 间隙中的滑膜区域由两名放射学专业水平不同的放射科医生进行独立盲检,以确定是否存在炎症。使用四个 b 值,表观扩散系数(ADC)= ADC(0,800)和简化的 3T IVIM 方法参数真实扩散系数(D1)= ADC(50,800),D= ADC(400,800)、f1= f(0,50,800),f2= f(0,400,800),假扩散系数(D*)= D*(0,50,400,800),ADClow= ADC(0,50),ADCdiff= ADClow - D。对 SIN 和 SIP 关节处的 IVIM 和 ADC 参数进行比较:与 SIN 区域(1.02 ± 0.16 × 10-3 mm2/s)相比,SIP 区域的 D 参数(1.23 ± 0.34 × 10-3 mm2/s)明显增加(P = 0.004)。相反,与 SIN 区域(16.19 ± 4.58 × 10-3 mm2/s)相比,SIP 区域的 D* 参数(21.78 ± 3.77 × 10-3 mm2/s)明显降低(P < 0.001)。当选择最佳临界值 1.11 × 10-3 mm2/s 时,D 值的灵敏度为 71%,特异度为 72% [曲线下面积 (AUC): 0.716)]。当选择最佳截断值 21.06 × 10-3 mm2/s 时,D* 值的灵敏度为 78.6%,特异度为 79.3%(AUC:0.829)。f1、f2 D*、D和ADCdiff的类间相关系数极佳,ADClow和D1的类间相关系数良好,但ADC的类间相关系数尚可:结论:通过简化的 IVIM 方法,只需使用四个 b 值就能评估 SIJ 滑膜炎症的存在,具有很高的灵敏度和特异性,无需使用造影剂:IVIM成像是一种无需使用造影剂、利用弥散加权成像即可深入了解组织灌注情况的技术。在这项研究中,我们首次证明了利用 IVIM,特别是通过伪扩散(D*)参数,无需造影剂即可检测 SIJ 滑膜炎症的潜力。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Diagnostic and interventional radiology
Diagnostic and interventional radiology Medicine-Radiology, Nuclear Medicine and Imaging
自引率
4.80%
发文量
0
期刊介绍: Diagnostic and Interventional Radiology (Diagn Interv Radiol) is the open access, online-only official publication of Turkish Society of Radiology. It is published bimonthly and the journal’s publication language is English. The journal is a medium for original articles, reviews, pictorial essays, technical notes related to all fields of diagnostic and interventional radiology.
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