A Study Using Magnetic Resonance Imaging in Assessing the Activity of Marrow Edema of Sacroiliac Joints in Early Ankylosing Spondylitis

Purpose: This paper aimed to investigate the value of SPARCC score and ADC value in evaluating the activity of sacroiliac arthritis in early AS, and to explore the correlations between SPARCC score and clinical activity evaluation indexes. These results can provide more reliable reference for clinical evaluation of AS activity. Methods A total of 43 patients with early AS underwent MR examinations using T 1 WI, T 2 WI, STIR and DWI sequences, included 30 males and 13 females, with a median age of (26.52 ± 3.28) years.All patients were divided into the active group and stable group by the BASDAI scoring. The values of ASDAS-ESR and ASDAS-CRP were calculated according to the values of ESR and CRP combined with clinical pain score. The non-parametric test was used as the main statistical method, and the Spearman Correlation Analysis was used to analyze the correlations between MRI parameters and clinical activity indicators. In addition, ROC curves were drawn to evaluate MRI effective parameters and clinical inflammatory indexes. Results The values of BASDAI, ESR, CRP, ASDAS-ESR and ASDAS-CRP were 5.60 ± 1.10scores,21.00 ± 16.25mm/h,12.60 ± 15.92mg/l,2.73 ± 1.25 and 3.13 ± 1.64 in the active group, while 4.90 ± 0.80scores,14.00 ± 11.00mm/h,3.03 ± 2.46mg/L, 1.27 ± 0.57 and 1.41 ± 0.77 in the stable group(p < 0.05). The SPARCC scoring and ADC values in the active group were higher than those in the stable group (p < 0.05). SPARCC scoring had the highest correlation with ASDAS-CRP (r = 0.806), while the ADC values were moderately correlated with ASDAS-CRP. Furthermore, we founded that ASDAS-CRP had the highest efficacy (AUC = 0.933) in clinical indexes, while SPARCC scoring was the most effective (AUC = 0.887) for the evaluation on MRI. Conclusions It can be concluded that MRI evaluation indexes were more reliable than clinical indicators for the AS activity. ASDAS-CRP had the highest efficacy and specificity for the evaluation of early AS, while SPARCC scoring had the highest efficacy and best sensitivity on MRI.