弥散加权成像对小儿骶髂关节的评价。

IF 3.3 2区 医学 Q1 RHEUMATOLOGY
Michael L Francavilla, Timothy G Brandon, Dmitry Khrichenko, Rui Xiao, Nancy A Chauvin, Asef Khwaja, Pamela F Weiss
{"title":"弥散加权成像对小儿骶髂关节的评价。","authors":"Michael L Francavilla, Timothy G Brandon, Dmitry Khrichenko, Rui Xiao, Nancy A Chauvin, Asef Khwaja, Pamela F Weiss","doi":"10.1002/acr.25661","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Maturational signal in the sacroiliac joint (SIJ) of skeletally immature youth is often misinterpreted as inflammation. Diagnostic tools that improve specificity are greatly needed. Apparent diffusion coefficient (ADC) values from diffusion-weighted imaging (DWI), when used with standard imaging, may enhance diagnostic accuracy. We aimed to define normative pediatric ADC values and establish thresholds to distinguish normal from inflammatory SIJ signals.</p><p><strong>Methods: </strong>ADC values were measured using circular regions of interest (ROI) on the anterior, central, and posterior slices of the cartilaginous SIJs (36 total ROIs). Mean ADCs were analyzed by age group, bone (iliac or sacral), and joint height (superior, mid, inferior), accounting for within-subject clustering. In sacroiliitis cases, ROIs were placed on DWI at sites of increased signal on fluid-sensitive sequences. Thresholds differentiating normal and inflammatory signals were derived by age, bone, and joint height (ilium only), and assessed by area under the receiver operating characteristic (AUROC) and specificity.</p><p><strong>Results: </strong>The reference group included 86 youth. Inferior ilium ADC values were higher than mid/superior regions in all immature age groups (all p<0.0001) and decreased with age (p=0.0001). Sacral ADCs also declined with age (p=0.0001). No age trend was observed in the superior/mid ilium (p=0.14). ADC thresholds distinguished normal from inflammatory signals with AUROC ≥0.90 in most iliac regions, except the peri-pubertal inferior ilium (AUROC 0.78). Sacral thresholds performed acceptably (AUROC ≥0.77), though were lower in the pre-pubertal group (AUROC 0.68).</p><p><strong>Conclusion: </strong>Age- and bone-specific ADC reference values were established and effectively differentiated normal from inflammatory SIJ signals.</p>","PeriodicalId":8406,"journal":{"name":"Arthritis Care & Research","volume":" ","pages":""},"PeriodicalIF":3.3000,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Diffusion-Weighted Imaging for the Evaluation of the Sacroiliac Joint in Pediatric Patients.\",\"authors\":\"Michael L Francavilla, Timothy G Brandon, Dmitry Khrichenko, Rui Xiao, Nancy A Chauvin, Asef Khwaja, Pamela F Weiss\",\"doi\":\"10.1002/acr.25661\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Maturational signal in the sacroiliac joint (SIJ) of skeletally immature youth is often misinterpreted as inflammation. Diagnostic tools that improve specificity are greatly needed. Apparent diffusion coefficient (ADC) values from diffusion-weighted imaging (DWI), when used with standard imaging, may enhance diagnostic accuracy. We aimed to define normative pediatric ADC values and establish thresholds to distinguish normal from inflammatory SIJ signals.</p><p><strong>Methods: </strong>ADC values were measured using circular regions of interest (ROI) on the anterior, central, and posterior slices of the cartilaginous SIJs (36 total ROIs). Mean ADCs were analyzed by age group, bone (iliac or sacral), and joint height (superior, mid, inferior), accounting for within-subject clustering. In sacroiliitis cases, ROIs were placed on DWI at sites of increased signal on fluid-sensitive sequences. Thresholds differentiating normal and inflammatory signals were derived by age, bone, and joint height (ilium only), and assessed by area under the receiver operating characteristic (AUROC) and specificity.</p><p><strong>Results: </strong>The reference group included 86 youth. Inferior ilium ADC values were higher than mid/superior regions in all immature age groups (all p<0.0001) and decreased with age (p=0.0001). Sacral ADCs also declined with age (p=0.0001). No age trend was observed in the superior/mid ilium (p=0.14). ADC thresholds distinguished normal from inflammatory signals with AUROC ≥0.90 in most iliac regions, except the peri-pubertal inferior ilium (AUROC 0.78). Sacral thresholds performed acceptably (AUROC ≥0.77), though were lower in the pre-pubertal group (AUROC 0.68).</p><p><strong>Conclusion: </strong>Age- and bone-specific ADC reference values were established and effectively differentiated normal from inflammatory SIJ signals.</p>\",\"PeriodicalId\":8406,\"journal\":{\"name\":\"Arthritis Care & Research\",\"volume\":\" \",\"pages\":\"\"},\"PeriodicalIF\":3.3000,\"publicationDate\":\"2025-10-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Arthritis Care & Research\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1002/acr.25661\",\"RegionNum\":2,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"RHEUMATOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Arthritis Care & Research","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1002/acr.25661","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"RHEUMATOLOGY","Score":null,"Total":0}
引用次数: 0

摘要

背景:骶髂关节(SIJ)的成熟信号经常被误解为炎症。提高特异性的诊断工具是非常必要的。当弥散加权成像(DWI)的表观扩散系数(ADC)值与标准成像一起使用时,可以提高诊断的准确性。我们的目的是定义标准的儿童ADC值,并建立区分正常和炎症SIJ信号的阈值。方法:采用软骨sij前、中、后片的圆形感兴趣区(ROI)测量ADC值(共36个ROI)。平均adc按年龄组、骨骼(髂骨或骶骨)和关节高度(上、中、下)进行分析,并考虑受试者内聚类。在骶髂炎病例中,在液体敏感序列上信号增加的部位,在DWI上放置roi。区分正常信号和炎症信号的阈值由年龄、骨骼和关节高度(仅髂骨)得出,并通过受者操作特征下面积(AUROC)和特异性进行评估。结果:对照组86例。所有未成熟年龄组的下髂骨ADC值均高于中/上区域(均为p)。结论:建立了年龄和骨特异性ADC参考值,并有效区分了正常和炎症性SIJ信号。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Diffusion-Weighted Imaging for the Evaluation of the Sacroiliac Joint in Pediatric Patients.

Background: Maturational signal in the sacroiliac joint (SIJ) of skeletally immature youth is often misinterpreted as inflammation. Diagnostic tools that improve specificity are greatly needed. Apparent diffusion coefficient (ADC) values from diffusion-weighted imaging (DWI), when used with standard imaging, may enhance diagnostic accuracy. We aimed to define normative pediatric ADC values and establish thresholds to distinguish normal from inflammatory SIJ signals.

Methods: ADC values were measured using circular regions of interest (ROI) on the anterior, central, and posterior slices of the cartilaginous SIJs (36 total ROIs). Mean ADCs were analyzed by age group, bone (iliac or sacral), and joint height (superior, mid, inferior), accounting for within-subject clustering. In sacroiliitis cases, ROIs were placed on DWI at sites of increased signal on fluid-sensitive sequences. Thresholds differentiating normal and inflammatory signals were derived by age, bone, and joint height (ilium only), and assessed by area under the receiver operating characteristic (AUROC) and specificity.

Results: The reference group included 86 youth. Inferior ilium ADC values were higher than mid/superior regions in all immature age groups (all p<0.0001) and decreased with age (p=0.0001). Sacral ADCs also declined with age (p=0.0001). No age trend was observed in the superior/mid ilium (p=0.14). ADC thresholds distinguished normal from inflammatory signals with AUROC ≥0.90 in most iliac regions, except the peri-pubertal inferior ilium (AUROC 0.78). Sacral thresholds performed acceptably (AUROC ≥0.77), though were lower in the pre-pubertal group (AUROC 0.68).

Conclusion: Age- and bone-specific ADC reference values were established and effectively differentiated normal from inflammatory SIJ signals.

求助全文
通过发布文献求助,成功后即可免费获取论文全文。 去求助
来源期刊
CiteScore
9.40
自引率
6.40%
发文量
368
审稿时长
3-6 weeks
期刊介绍: Arthritis Care & Research, an official journal of the American College of Rheumatology and the Association of Rheumatology Health Professionals (a division of the College), is a peer-reviewed publication that publishes original research, review articles, and editorials that promote excellence in the clinical practice of rheumatology. Relevant to the care of individuals with rheumatic diseases, major topics are evidence-based practice studies, clinical problems, practice guidelines, educational, social, and public health issues, health economics, health care policy, and future trends in rheumatology practice.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:604180095
Book学术官方微信