Quantification of Fat Metaplasia in the Sacroiliac Joints of Patients With Axial Spondyloarthritis by Chemical Shift-Encoded MRI: A Diagnostic Trial
ObjectiveTo study the diagnostic performance of chemical shift-encoded MRI (CSE-MRI) in the diagnosis of axial spondyloarthritis (axSpA).MethodsCSE-MRI images were acquired for consecutive patients complaining of back pain as well as healthy volunteers. Proton density fat fraction (PDFF) values were...
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Frontiers Media S.A.
2022-01-01
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| Series: | Frontiers in Immunology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fimmu.2021.811672/full |
| _version_ | 1819284175842181120 |
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| author | Dong Liu Churong Lin Budian Liu Jun Qi Huiquan Wen Liudan Tu Qiujing Wei Qingcong Kong Ya Xie Jieruo Gu |
| author_facet | Dong Liu Churong Lin Budian Liu Jun Qi Huiquan Wen Liudan Tu Qiujing Wei Qingcong Kong Ya Xie Jieruo Gu |
| author_sort | Dong Liu |
| collection | DOAJ |
| description | ObjectiveTo study the diagnostic performance of chemical shift-encoded MRI (CSE-MRI) in the diagnosis of axial spondyloarthritis (axSpA).MethodsCSE-MRI images were acquired for consecutive patients complaining of back pain as well as healthy volunteers. Proton density fat fraction (PDFF) values were measured independently by two readers. Diagnostic performance of CSE-MRI was analyzed by sensitivity analysis and ROC curve analysis. Logistic regression analysis was employed to investigate the risk factors of extensive fat deposition in the SIJs.ResultsA total of 52 r-axSpA patients, 37 nr-axSpA patients, 24 non-SpA patients and 34 healthy volunteers were included. Mean PDFF values in the SIJs of patients with r-axSpA and nr-axSpA (72.7% and 64.5%) were significantly higher than non-SpA patients and healthy volunteers (56.0% and 57.6%) (p<0.001). By defining extensive fat deposition in the SIJs as ≥8 ROIs with PDFF values over 70%, its sensitivity and specificity in diagnosing axSpA reached 72.47% and 86.21%%. By joining bone marrow edema (BME) with ≥8 ROIs (PDFF>70%), 22 (24.71%) and 23 (25.84%) more axSpA patients were classified as SIJ MRI (+) by reader 1 and 2, but specificities decreased by 15.52% and 10.34%. Multivariate logistic regression analysis confirmed longer disease duration as the independent risk factor of extensive fat deposition in SIJs (OR=1.15, 95%CI[1.03, 1.32]), while bDMARDs medication was a protective factor (OR=0.15, 95%CI[0.04, 0.51]).ConclusionCSE-MRI is a reliable tool to quantitively assess the fat metaplasia in the SIJs of axSpA patients. Extensive fat deposition in the SIJs could add incremental diagnostic value to BME, but at the cost of decreased specificities. |
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| issn | 1664-3224 |
| language | English |
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| publishDate | 2022-01-01 |
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| spelling | doaj.art-057d879d458945c5885bf0f6b1bddff32022-12-21T17:21:57ZengFrontiers Media S.A.Frontiers in Immunology1664-32242022-01-011210.3389/fimmu.2021.811672811672Quantification of Fat Metaplasia in the Sacroiliac Joints of Patients With Axial Spondyloarthritis by Chemical Shift-Encoded MRI: A Diagnostic TrialDong Liu0Churong Lin1Budian Liu2Jun Qi3Huiquan Wen4Liudan Tu5Qiujing Wei6Qingcong Kong7Ya Xie8Jieruo Gu9Department of Rheumatology, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, ChinaRadiology Department, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, ChinaDepartment of Rheumatology, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, ChinaDepartment of Rheumatology, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, ChinaRadiology Department, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, ChinaDepartment of Rheumatology, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, ChinaDepartment of Rheumatology, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, ChinaRadiology Department, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, ChinaDepartment of Rheumatology, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, ChinaDepartment of Rheumatology, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, ChinaObjectiveTo study the diagnostic performance of chemical shift-encoded MRI (CSE-MRI) in the diagnosis of axial spondyloarthritis (axSpA).MethodsCSE-MRI images were acquired for consecutive patients complaining of back pain as well as healthy volunteers. Proton density fat fraction (PDFF) values were measured independently by two readers. Diagnostic performance of CSE-MRI was analyzed by sensitivity analysis and ROC curve analysis. Logistic regression analysis was employed to investigate the risk factors of extensive fat deposition in the SIJs.ResultsA total of 52 r-axSpA patients, 37 nr-axSpA patients, 24 non-SpA patients and 34 healthy volunteers were included. Mean PDFF values in the SIJs of patients with r-axSpA and nr-axSpA (72.7% and 64.5%) were significantly higher than non-SpA patients and healthy volunteers (56.0% and 57.6%) (p<0.001). By defining extensive fat deposition in the SIJs as ≥8 ROIs with PDFF values over 70%, its sensitivity and specificity in diagnosing axSpA reached 72.47% and 86.21%%. By joining bone marrow edema (BME) with ≥8 ROIs (PDFF>70%), 22 (24.71%) and 23 (25.84%) more axSpA patients were classified as SIJ MRI (+) by reader 1 and 2, but specificities decreased by 15.52% and 10.34%. Multivariate logistic regression analysis confirmed longer disease duration as the independent risk factor of extensive fat deposition in SIJs (OR=1.15, 95%CI[1.03, 1.32]), while bDMARDs medication was a protective factor (OR=0.15, 95%CI[0.04, 0.51]).ConclusionCSE-MRI is a reliable tool to quantitively assess the fat metaplasia in the SIJs of axSpA patients. Extensive fat deposition in the SIJs could add incremental diagnostic value to BME, but at the cost of decreased specificities.https://www.frontiersin.org/articles/10.3389/fimmu.2021.811672/fullaxial spondyloarthritismagnetic resonance imagingfat metaplasiachemical shift-encoded sequencequantitative imaging |
| spellingShingle | Dong Liu Churong Lin Budian Liu Jun Qi Huiquan Wen Liudan Tu Qiujing Wei Qingcong Kong Ya Xie Jieruo Gu Quantification of Fat Metaplasia in the Sacroiliac Joints of Patients With Axial Spondyloarthritis by Chemical Shift-Encoded MRI: A Diagnostic Trial Frontiers in Immunology axial spondyloarthritis magnetic resonance imaging fat metaplasia chemical shift-encoded sequence quantitative imaging |
| title | Quantification of Fat Metaplasia in the Sacroiliac Joints of Patients With Axial Spondyloarthritis by Chemical Shift-Encoded MRI: A Diagnostic Trial |
| title_full | Quantification of Fat Metaplasia in the Sacroiliac Joints of Patients With Axial Spondyloarthritis by Chemical Shift-Encoded MRI: A Diagnostic Trial |
| title_fullStr | Quantification of Fat Metaplasia in the Sacroiliac Joints of Patients With Axial Spondyloarthritis by Chemical Shift-Encoded MRI: A Diagnostic Trial |
| title_full_unstemmed | Quantification of Fat Metaplasia in the Sacroiliac Joints of Patients With Axial Spondyloarthritis by Chemical Shift-Encoded MRI: A Diagnostic Trial |
| title_short | Quantification of Fat Metaplasia in the Sacroiliac Joints of Patients With Axial Spondyloarthritis by Chemical Shift-Encoded MRI: A Diagnostic Trial |
| title_sort | quantification of fat metaplasia in the sacroiliac joints of patients with axial spondyloarthritis by chemical shift encoded mri a diagnostic trial |
| topic | axial spondyloarthritis magnetic resonance imaging fat metaplasia chemical shift-encoded sequence quantitative imaging |
| url | https://www.frontiersin.org/articles/10.3389/fimmu.2021.811672/full |
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