scholarly journals AB0007 VALUE OF ULTRASOUND IN ASSESSMENT OF ACTIVE SACROILIITIS IN PATIENTS WITH AXIAL SPONDYLOARTHRITIS

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 1307.3-1307
Author(s):  
M. Chen ◽  
S. M. Dai

Background:The inflammatory of the sacroiliac joints (SIJs) called sacroiliitis, is a characteristic of axial Spondyloarthritis (axSpA). The detection of sacroiliitis is meaningful to prevent irreversible changes. The tool of assessment of sacroiliitis including radiographs, computed tomography (CT) and magnetic resonance imaging (MRI). Ultrasound (US) has also been used in the evaluation of sacroiliitis in recent years.Objectives:We aimed to evaluate the value of US in the assessment of active sacroiliitis in axSpA patients.Methods:Fifty-one patients fulfilling Assessment of SpondyloArthritis International Society (ASAS) 2009 criteria for the classification of axSpA were recruited1. All the patients underwent MRI and US evaluation of bilateral SIJs. MRI was performed using the sequences of T1WI, T2WI and fat suppression T2WI (FS-T2WI). MRI sacroiliitis was defined according to ASAS criteria of active sacroiliitis2. The Spondyloarthritis research Consortium of Canada (SPARCC) scoring was used to evaluate the inflammatory lesions in SIJs3. US were performed by an ultrasonographer with 10 years of experience in musculoskeletal ultrasound, and resistive index (RI) value was recorded. The US sacroiliitis was defined as the presence of more flow signals at SIJ with an RI ≤ 0.75. The HLA-B27, erythrocyte sedimentation rate (ESR) and hypersensitive C-reactive protein (hsCRP) were also evaluated. Consistency rate, sensitivity, specificity, positive predictive values (PPV) and negative predictive values (NPV)for the diagnosis of sacroiliitis by US were calculated, using MRI as the gold standard.Results:Of the 51 patients, 24 were female and 27 were male. The HLA-B27 positive rate was 90.2% (46/51). The consistency rate of US and MRI sacroiliitis was 55.88 (57/102). The sensitivity and specificity of US for the diagnosis of sacroiliitis were 55.93 (33/59) and 55.81 (24/43) respectively. The PPV and NPV were 63.46 (33/52) and 48 (24/50) respectively. There was no significant difference in ESR and hsCRP between the US positive sacroiliitis and the others (P= 0.7477 and 0.2268, respectively). The SPARCC scores have no significant difference between the US positive sacroiliitis and the others (P= 0.2206). The RI was not significantly associated with the MRI SPARCC score (P=0.4236).Conclusion:US may be an optional method for preliminary screening sacroiliitis. But its reliability as a diagnostic method needs further verification.References:[1]Rudwaleit M, et al. The development of Assessment of SpondyloArthritis international Society classification criteria for axial spondyloarthritis (part II): validation and final selection. Ann Rheum Dis. 2009; 68(6):777-83[2]Rudwaleit M, et al. Defining active sacroiliitis on magnetic resonance imaging (MRI) for classification of axial spondyloarthritis: a consensual approach by the ASAS/OMERACT MRI group. Ann Rheum Dis 2009;68(10):1520–7[3]Maksymowych WP, et al. Spondyloarthritis research Consortium of Canada magnetic resonance imaging index for assessment of sacroiliac joint inflammation in ankylosing spondylitis. Arthritis Rheum.2005;53(5):703-9.Acknowledgments:This project was supported by grants from National Natural Science Foundation of China (81900795)Disclosure of Interests:None declared

2021 ◽  
Vol 49 (9) ◽  
pp. 030006052097309
Author(s):  
Xueli Zhu ◽  
Yi Cao ◽  
Ruidie Li ◽  
Mingxia Zhu ◽  
Xin Chen

Objective We compared the diagnostic values of mammography and magnetic resonance imaging (MRI) for evaluating breast masses. Methods We retrospectively analyzed mammography, MRI, and histopathological data for 377 patients with breast masses on mammography, including 73 benign and 304 malignant masses. Results The sensitivities and negative predictive values (NPVs) were significantly higher for MRI compared with mammography for detecting breast cancer (98.4% vs. 89.8% and 87.8% vs. 46.6%, respectively). The specificity and positive predictive values (PPV) were similar for both techniques. Compared with mammography alone, mammography plus MRI improved the specificity (67.1% vs. 37.0%) and PPV (91.8% vs. 85.6%), but there was no significant difference in sensitivity or NPV. Compared with MRI alone, the combination significantly improved the specificity (67.1% vs. 49.3%), but the sensitivity (88.5% vs. 98.4%) and NPV (58.3% vs. 87.8%) were reduced, and the PPV was similar in both groups. There was no significant difference between mammography and MRI in terms of sensitivity or specificity among 81 patients with breast masses with calcification. Conclusion Breast MRI improved the sensitivity and NPV for breast cancer detection. Combining MRI and mammography improved the specificity and PPV, but MRI offered no advantage in patients with breast masses with calcification.


Reumatismo ◽  
2016 ◽  
Vol 68 (2) ◽  
pp. 72 ◽  
Author(s):  
M. Lorenzin ◽  
A. Ortolan ◽  
P. Frallonardo ◽  
S. Vio ◽  
C. Lacognata ◽  
...  

Our aim was to determine the prevalence of spine and sacroiliac joint (SIJ) lesions on magnetic resonance imaging (MRI) in patients with early axial spondyloarthritis (axSpA) and their correlation with disease activity indices. Sixty patients with low back pain (LBP) (≥3 months, ≤2 years, onset ≤45 years), attending the SpA-clinic of the Unità Operativa Complessa Reumatologia of Padova [SpondyloArthritis-Caught-Early (SPACE) study], were studied following a protocol including physical examination, questionnaires, laboratory tests, X-rays and spine and SIJ MRI. Positive spine and SIJ MRI and X-rays images were scored independently by 2 readers using the SPARCC method, modified Stoke ankylosing spondylitis spine score and New York criteria. The axial pain and localization of MRI-lesions were referred to 4 sites: cervical/thoracic/lumbar spine and SIJ. All patients were classified into three groups: patients with signs of radiographic sacroiliitis (r-axSpA), patients without signs of r-axSpA but with signs of sacroiliitis on MRI (nr-axSpA MRI SIJ+), patients without signs of sacroiliitis on MRI and X-rays (nr-axSpA MRI SIJ-). The median age at LBP onset was 29.05±8.38 years; 51.6% of patients showed bone marrow edema (BME) in spine-MRI and 56.7% of patients in SIJ-MRI. Signs of enthesitis were found in 55% of patients in the thoracic district. Of the 55% of patients with BME on spine-MRI, 15% presented presented a negative SIJMRI. There was a significant difference between these cohorts with regard to the prevalence of radiographic sacroiliitis, active sacroiliitis on MRI and SPARCC SIJ score. The site of pain correlated statistically with BME lesions in thoracic and buttock districts. Since positive spine-MRI images were observed in absence of sacroiliitis, we can hypothesize that this finding could have a diagnostic significance in axSpA suspected axSpA.


2019 ◽  
Vol 46 (11) ◽  
pp. 1445-1449 ◽  
Author(s):  
Xenofon Baraliakos ◽  
Florian Hoffmann ◽  
Xiaohu Deng ◽  
Yan-Yan Wang ◽  
Feng Huang ◽  
...  

Objective.The volumetric interpolated breath-hold examination (VIBE) magnetic resonance imaging (MRI) technique can visualize erosive cartilage defects in peripheral joints. We evaluated the ability of VIBE to detect erosions in sacroiliac joints (SIJ) of patients with axial spondyloarthritis (axSpA) compared to the established T1-weighted MRI sequence and computed tomography (CT).Methods.MRI (T1-weighted and VIBE) and CT scans of SIJ of 109 patients with axSpA were evaluated by 2 blinded readers based on SIJ quadrants (SQ). Erosions were defined according to Assessment of Spondyloarthritis international Society (ASAS) definitions. Scores were recorded if readers were in agreement.Results.Erosions were less frequently detected by CT (153 SQ) than by T1-weighted MRI (182 SQ; p = 0.008) and VIBE-MRI (199 SQ; p < 0.001 vs CT and p = 0.031 vs T1-weighted MRI). Taking CT as the gold standard, the sensitivity of VIBE-MRI (71.2%) was higher than that for T1-weighted MRI (63.4%), with similar specificity (87.3% vs 88%, respectively). In linear regression analysis, younger age was significantly associated with occurrence of erosions independently in VIBE-MRI (β = 0.384, p < 0.001) and T1-weighted MRI (β = 0.369, p < 0.001) compared to CT.Conclusion.The VIBE-MRI sequence was more sensitive than T1-weighted MRI in identifying erosive damage in the SIJ, especially in younger patients. This might be due to the ability of VIBE-MRI to identify structural changes in the cartilage that have not yet extended to the underlying bone, where CT seems to be superior.


2007 ◽  
Vol 48 (7) ◽  
pp. 755-762 ◽  
Author(s):  
A. Aalto ◽  
J. Sjöwall ◽  
L. Davidsson ◽  
P. Forsberg ◽  
Ö. Smedby

Background: Borrelia infections, especially chronic neuroborreliosis (NB), may cause considerable diagnostic problems. This diagnosis is based on symptoms and findings in the cerebrospinal fluid but is not always conclusive. Purpose: To evaluate brain magnetic resonance imaging (MRI) in chronic NB, to compare the findings with healthy controls, and to correlate MRI findings with disease duration. Material and Methods: Sixteen well-characterized patients with chronic NB and 16 matched controls were examined in a 1.5T scanner with a standard head coil. T1- (with and without gadolinium), T2-, and diffusion-weighted imaging plus fluid-attenuated inversion recovery (FLAIR) imaging were used. Results: White matter lesions and lesions in the basal ganglia were seen in 12 patients and 10 controls (no significant difference). Subependymal lesions were detected in patients down to the age of 25 and in the controls down to the age of 43. The number of lesions was correlated to age both in patients (ρ = 0.83, P<0.01) and in controls (ρ = 0.61, P<0.05), but not to the duration of disease. Most lesions were detected with FLAIR, but many also with T2-weighted imaging. Conclusion: A number of MRI findings were detected in patients with chronic NB, although the findings were unspecific when compared with matched controls and did not correlate with disease duration. However, subependymal lesions may constitute a potential finding in chronic NB.


2020 ◽  
Author(s):  
Monika Graeser ◽  
Simone Schrading ◽  
Oleg Gluz ◽  
Kevin Strobel ◽  
Christopher Herzog ◽  
...  

Abstract Background: Prediction of histological tumor size by post-neoadjuvant therapy (NAT) ultrasound and magnetic resonance imaging (MRI) was evaluated in different breast cancer subtypes.Methods: Imaging was performed after 12-week NAT in patients enrolled into three neoadjuvant WSG ADAPT subtrials. Imaging performance for prediction of tumor size was analyzed across increasing size ranges (≤10, ≤20 and ≤30 mm) and summarized using positive (PPV) and negative predictive values (NPV).Results: 248 and 588 patients had MRI and ultrasound, respectively. Tumor size was over- or underestimated by <10 mm in 4.4% and 21.8% of patients by MRI and in 10.2% and 15.8% by ultrasound. Overall, PPV (correctly predicted tumor size ≤10, ≤20 or ≤30 mm) of MRI and ultrasound increased from 0.61 and 0.72 for ≤10 mm tumors to 0.88 and 0.96 for ≤30 mm tumors; NPV (correctly predicted tumor size >10, >20 or >30 mm) decreased from 0.89 and 0.74 to 0.69 and 0.22. Across all tumor size ranges, ultrasound demonstrated higher PPV than MRI in HR+/HER2+ tumors while both methods had a similarly low PPV in HR-/HER2- and HR-/HER2+ tumors. MRI had a higher NPV than ultrasound with the exception of HR-/HER2- tumors measuring ≤10 and ≤20 mm where both methods had similar NPV. Conclusions: Ultrasound is less likely than MRI to underestimate the size of HR+/HER2+ tumors while MRI is associated with a lower risk to overestimate the size of HR+/HER2+ and HR-/HER2+ tumors. These findings may help to select the most optimal imaging approach for planning surgery after NAT. Trial registration: Clinicaltrials.gov, NCT01815242 (registration March 21, 2013, NCT01817452 (registration March 25, 2013), NCT01779206 (registration January 30, 2013).


2017 ◽  
Vol 68 (2) ◽  
pp. 116-121 ◽  
Author(s):  
Sharon E. Clarke ◽  
Dipan Mistry ◽  
Talal AlThubaiti ◽  
M. Naeem Khan ◽  
David Morris ◽  
...  

Purpose The purpose of this study was to evaluate the sensitivity, specificity, and positive and negative predictive values of the diffusion-weighted periodically rotated overlapping parallel lines with enhanced reconstruction (PROPELLER) technique in the detection of cholesteatoma at our institution with surgical confirmation in all cases. Methods A retrospective review of 21 consecutive patients who underwent diffusion-weighted PROPELLER magnetic resonance imaging (MRI) on a 1.5T MRI scanner prior to primary or revision/second-look surgery for suspected cholesteatoma from 2009-2012 was performed. Results Diffusion-weighted PROPELLER had a sensitivity of 75%, specificity of 60%, positive predictive value of 86%, and negative predictive value of 43%. In the 15 patients for whom the presence or absence of cholesteatoma was correctly predicted, there were 2 cases where the reported locations of diffusion restriction did not correspond to the location of the cholesteatoma observed at surgery. Conclusion On the basis of our retrospective study, we conclude that diffusion-weighted PROPELLER MRI is not sufficiently accurate to replace second look surgery at our institution.


2021 ◽  
Vol 20 (3) ◽  
pp. 324-329
Author(s):  
Bünyamin Güney ◽  
◽  
İbrahim Önder Yeniçeri ◽  
Emrah Doğan ◽  
Neşat Çullu ◽  
...  

Objective. The aim of this study is to evaluate the magnetic resonance imaging (MRI) findings of central neural system (CNS) superficial siderosis cases and the diagnostic contribution of the susceptibility-weighted imaging (SWI) sequence to conventional imaging. Method. TSE T2-weighted and SWI-MRI of 26 patients diagnosed as CNS-superficial siderosis (CNS-SS) were retrospectively evaluated with 3-Tesla MRI. The localization and type of involvement of SS were reviewed. Results. The CNS-SS were divided into two categories as central amyloid angiopathy-SS (CAA-SS) and non central amyloid angiopathy-SS (non-CAA-SS). In non-CAA cases, the involvement was typical (classic) in 5 cases and atypical in 9 cases. In 12 of these cases (85.7%), SS findings were observed on both turbo spine echo (TSE) T2 images and SWI imaging, while in 2 cases (14.3%) SS was detected only on SWI images. In 7 of the CAA-SS cases, involvement was focal type SS (58.33%), while 5 cases had diffuse type SS (41.67%) involvement. In the vast majority of cases (n = 10) of this type of SS, involvement was detected only in SWI images, while siderosis was not detected in TSE T2 images. In addition, occult cerebral vascular malformation accompanying SS, which can be observed only in the SWI sequence, was found in a total of 4 cases. In the cross-matching statistical analysis performed between CAA-SS and non-CAA-SS groups and subgroups, SWI was found to be significantly superior to T2 in detecting SS in the CAA-SS group (p:0,007). Conclusions. SWI imaging was superior in detecting SS and detecting cerebral occult vascular malformation in CAA-SS cases. Although the detectability of SS by SWI was high in other groups, no statistically significant difference was found. Under these circumstances, we think that it will be beneficial to add SWI imaging to the routine imaging protocol in cases with suspected CNS-SS.


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