Correlation Between Diagnostic Imaging Findings of Sacroiliitis and Inflammation Parameters

Abstract

Objectives Sacroiliitis is an inflammation of the sacroiliac joints. Diagnostic imaging has a very important role in the diagnosis of sacroiliac involvement in the disease process. In addition, laboratory parameters can also be useful for the detection of inflammation. This study aims to investigate the relationship between active sacroiliitis and subclinical inflammation parameters in patients who underwent MRI and 99mTc-methylene diphosphonate (MDP) bone scintigraphy.

Material and Methods This study includes 65 patients with suspected spondyloarthritis (SpA). Patients who had a sacroiliac MRI, a 99mTc-MDP bone scintigraphy and a complete blood count (CBC) within 3 months were reviewed retrospectively. Sacroiliac joints were evaluated bilaterally by using bone scintigraphy and MRI. Blood inflammation parameters were further assessed regarding evidence of probable sacroiliitis.

Results Significant differences were reported between MRI groups for sacroiliac indices (SII) (p=0.003), neutrophil-to-lymphocyte ratio (NLR) (p=0.008), C-reactive protein (CRP) (p = 0.037), and white blood cell (WBC) count (p=0.031). A significant correlation was found between active sacroiliitis and SII (p=0.001), CRP (p=0.000), erythrocyte sedimentation rate (ESR) (p=0.000), and NLR (p=0.001). Based on the ROC curve analysis, SII was found to have a sensitivity of 64.3% and specificity of 69.8%; NLR was found to have a sensitivity of 64.3% and specificity of 73.3% for diagnosing active sacroiliitis.

Conclusions Subclinical inflammation indices obtained from CBC and, particularly, NLR may contribute to disease activity assessment like acute-phase reactants. However, this needs to be confirmed in further studies.

Zusammenfassung

Hintergrund Die Sakroiliitis ist eine Entzündung der Iliosakralgelenke. Bei der Diagnose einer Beteiligung der Iliosakralgelenke am Krankheitsprozess spielt die diagnostische Bildgebung eine sehr wichtige Rolle. Darüber hinaus können auch Laborparameter zum Nachweis von Entzündungen nützlich sein. Ziel dieser Studie ist die Untersuchung der Beziehung zwischen aktiver Sakroiliitis und subklinischen Entzündungsparametern bei Patienten, bei denen eine MRT-Untersuchung und eine Knochenszintigrafie mit 99mTc-Methylendiphosphonat (MDP) durchgeführt wurde.

Material und Methoden In diese Studie wurden Patienten mit Sakroiliitis, bei denen eine MRT und eine Knochenszintigrafie mit 99mTc-MDP durchgeführt wurden und ein vollständiges Blutbild vorlag, innerhalb von 3 Monaten retrospektiv nachuntersucht. Es erfolgte eine bilaterale Beurteilung der Iliosakralgelenke mittels Knochenszintigrafie und MRT. Außerdem wurde anhand der Entzündungsparameter im Blut festgestellt, ob Hinweise auf eine Sakroiliitis vorlagen.

Ergebnisse Es fanden sich signifikante Unterschiede zwischen den MRT-Gruppen in Bezug auf iliosakrale Indizes (SII) (p=0,003), Neutrophilen-Lymphozyten-Verhältnis (NLR) (p=0,008), C-reaktives Protein (CRP) (p=0,037) und Leukozytenzahl (p=0,031). Eine signifikante Korrelation zeigte sich zwischen aktiver Sakroillitis und SII (p=0,001), CRP (p=0,000), Erythrozytensedimentationrate (ESR) (p=0,000) und NLR (p=0,001). Basierend auf der ROC-Kurvenanalyse wurden für SII zur Diagnose einer aktiven Sakroiliitis eine Sensitivität von 64,3% und eine Spezifität von 69,8% sowie für NLR eine Sensitivität von 64,3% und eine Spezifität von 73,3% ermittelt.

Schlussfolgerungen Subklinische Entzündungsindizes, die anhand des Blutbilds und insbesondere des NLR bestimmt werden, können wie Akutphasenreaktanten zur Beurteilung der Krankheitsaktivität beitragen. Dies muss jedoch durch weitere Studien bestätigt werden.

Key words

sacroiliitis - neutrophil-to-lymphocyte ratio - magnetic resonance imaging - scintigraphy

Schlüsselwörter

Sakroiliitis - Neutrophil zu Lymphozyten Verhältnis - Szintigrafie - Magnetresonanztomografie

Publication History

Article published online:
05 May 2021

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