Diagnosis of early sacroiliitis in seronegative spondyloarthropathiesby DWI and correlation of clinical and laboratory findings with ADC values

摘要

Purpose: Sacroiliitis is one of the diagnostic criteria of seronegative SpA. The purpose of our study is toshow the signal characteristics of the sacral and iliac surfaces by DWI which may contribute in earlydiagnosis of sacroiliitis and investigate the correlation between ADC values and clinical and laboratoryparameters.Materials and methods: 62 patients with inflammatory low back pain, with a history or suspect of seroneg-ative SpA are enrolled into the study. 40 age and sex-matched subjects without SpA constituted thecontrol group. After obtaining routine T1 and T2 weighted sequences, echo planar imaging at b values of0, 400 and 800 was performed. ADC values on both surfaces of the both sacroiliac joints were measuredin all subjects. The CRP and sedimentation results and the presence of arthritis and enthesitis were alsocorrelated with the ADC values.Results: ADC values on both surfaces of the both sacroiliac joints were found 0.23 10?3mm2/sn in thecontrol group. In the patient group, mean ADC value of 0.48 10?3mm2/sn was obtained (p < 0.001),which was statistically significant, compatible with the increased diffusion due to medullary edema inearly sacroiliitis. There was a slight correlation between CRP and ADC values; presumed to be showing therelation between the activity of the disease and the active inflammation on DWI. There was no correlationbetween arthritis and enthesitis and the ADC values (p > 0.001).Conclusion: DWI, by measuring ADC values, adds significant information in the early diagnosis of sacroili-itis and may help to evaluate the efficiency of the treatment.