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Comparison of apparent diffusion coefficient in spondylarthritis axial active inflammatory lesions and type 1 Modic
Benjamin Dallaudière1, Raphaël Dautry2, Pierre-Marie Preux3
1Hôpital Bichat - Claude Bernard, Service de Radiologie, 46, rue Henri Huchard, Paris 75018, France; Hôpital Bichat - Claude Bernard, Inserm U698, 46, rue Henri Huchard, Paris 75018, France; Université Paris Diderot, Paris, France.
Objective:
The goal of this study was to evaluate whether the values of ADC in spondylarthritis axial active inflammatory lesions are different from ADC values in type 1 Modic changes.
Subjects And Methods:
95 patients with recent lumbar pain, including 46 patients with diagnosed or suspected spondylarthritis and 49 patients with purely degenerative history, underwent spine MRI. T1w, STIR, and diffusion-weighted images (DWI) were obtained. Two musculoskeletal radiologists interpreted the images. Axial active inflammatory lesions from the SpA group and type 1 Modic changes from the degenerative group were identified on T1w and STIR sequences. ADC values from these lesions and from healthy subchondral bone were compared.
Results:
All axial active inflammatory lesions (n=27) and type 1 Modic changes (n=22) identified in T1w and STIR images were visible on DWI. ADC values were significantly higher (p<0.05) for axial active inflammatory lesions (median=0.788×10(-3)mm(2)/s, IQR 25-75 [0.7×10(-3)mm(2)/s; 0.9×10(-3)mm(2)/s]) than for type 1 Modic changes (median=0.585×10(-3)mm(2)/s, IQR 25-75 [0.55×10(-3)mm(2)/s; 0.60×10(-3)mm(2)/s]) and normal subchondral bone (median=0.443×10(-3)mm(2)/s, IQR 25-75 [0.40×10(-3)mm(2)/s; 0.50×10(-3)mm(2)/s]). Intra-class correlation coefficients for intra- and inter-reader ADC values comparison were excellent (0.89 and 0.98 respectively).
Conclusion:
DWI is a sensitive and fast sequence that offer the possibility of quantifying diffusion coefficients of the lesions, which could help to discriminate between spondylarthritis axial active inflammatory and type 1 Modic changes.
