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Spinal inflammation by magnetic resonance imaging in patients with ankylosing spondylitis: association with disease
Sefika Konca1, Dilek Keskin, Deniz Cılız
1Ankara Numune Training and Research Hospital, Physical Medicine and Rehabilitation Clinic, Ankara, Turkey.
Abstract:
Magnetic resonance imaging (MRI) has major contribution in early diagnosis of ankylosing spondylitis (AS). As it is difficult to determine disease activity owing to the lack of close relation between laboratory tests, clinical findings and imaging, MRI has been used as an objective outcome measure. The aim of this study is to investigate the relation between spinal MRI findings with disease activity and other outcome measures. Fifty patients fulfilling modified New York criteria for AS were enrolled to the study. All the patients were evaluated with Bath AS Disease Activity Index (BASDAI), AS Disease Activity Score (ASDAS), Bath AS Functional Index (BASFI), Bath AS Metrology Index (BASMI), Bath AS Radiology Index (BASRI) and As Quality of Life. Erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) were measured as laboratory parameters, and ASspiMR scores were determined by spinal MRI. The median total ASspiMR-a score was 5.2. Spinal inflammation was evaluated in spinal segments, and thoracic segments had the highest mean ASspiMR-a level (3.1 ± 5.94). Cervical and lumbar ASspiMR were correlated with only BASRI, and total ASspiMR score was correlated with BASRI, BASMI and CRP. Thoracic ASspiMR score was correlated with patient's and doctor's global assessments, BASFI, BASMI, BASRI, ASDAS A, ASDAS B, ASDAS C, ASDAS D, ESR and CRP (P < 0.05). According to our results, the thoracic spine was the most related region with disease activity parameters and clinical outcome measures, so we suggest thoracic spine MRI evaluation in order to determine the disease activity.
Insights
Magnetic resonance imaging (MRI) is crucial for diagnosing ankylosing spondylitis (AS). Thoracic spine MRI findings strongly correlate with disease activity and clinical outcomes, suggesting its utility for assessing disease severity.
Area of Science:
- Rheumatology
- Radiology
- Medical Imaging
Background:
- Ankylosing spondylitis (AS) diagnosis and activity assessment are challenging due to poor correlation between lab tests, clinical findings, and imaging.
- Magnetic resonance imaging (MRI) offers an objective measure for disease activity in AS.
- Assessing the relationship between spinal MRI findings and various disease activity metrics is essential.
Purpose of the Study:
- To investigate the correlation between spinal MRI findings and disease activity measures in patients with AS.
- To determine which spinal region's MRI findings best reflect disease activity and clinical outcomes.
Main Methods:
- Fifty patients meeting the modified New York criteria for AS were included.
- Patients underwent assessments including BASDAI, ASDAS, BASFI, BASMI, BASRI, Quality of Life, ESR, and CRP.
- Spinal MRI was performed to determine ASspiMR scores for different spinal segments.
Main Results:
- The median total ASspiMR-a score was 5.2, with the thoracic spine showing the highest mean ASspiMR-a level (3.1 ± 5.94).
- Cervical and lumbar ASspiMR scores correlated only with BASRI.
- Thoracic ASspiMR scores demonstrated significant correlations with multiple disease activity indices (BASDAI, ASDAS, ESR, CRP) and functional/radiological measures (BASFI, BASMI, BASRI).
Conclusions:
- The thoracic spine is the most relevant region for MRI evaluation in AS, showing strong associations with disease activity and clinical outcomes.
- Thoracic spine MRI assessment is recommended for accurately determining disease activity in ankylosing spondylitis.
