Background With the today`s advanced magnetic resonance imaging (MRI) techniques, the pathologic features of ankylosing spondylitis (AS) can be detected early and promptly treatment.

Objectives This study aimed to determine the value of diffusion-weighted MR imaging (DWI) in determined of AS treatment strategy and assess the role of quantitative MRI in the evaluation of AS treatment outcome.

Methods 52 patients with the diagnosis of early AS were included in this study. Disease activity was measured according to clinical instruments and laboratory tests. For each patient, both inflamed sacroiliac (S-I) joint lesion was checked quantitatively at first diagnosis by diffusion-weighted MR imaging (DWI) and measured the apparent diffusion coefficient (ADC). Based on ADC value, low ADC value group were treated with conventional NSAIDs and high ADC value group were treated with TNF-α inhibitor. all subjects were revaluated continuously by pelvis multi-directional computer tomography (MDCT) for bone change in sacroiliac joint, after treatment.

Results The high ADC value patient had higher BASDIA score, ESR and CRP than low ADC value patients relatively. The clinical parameters diminished significantly with regression of the inflammatory activity after treated with TNF-α inhibitor or NSAIDs. But paradoxically, one patient who was low ADC value and treated with NSAID had radiologic change of S-I joint and no change of ADC value in follow up MRI.

• Download figure
• Open in new tab
• Download powerpoint

Conclusions The ADC value measured by DWI maybe predicted treatment response.

1. Braun J, Sieper J. Ankylosing spondylitis. Lancet 2007;369:1379–90.

Disclosure of Interest None declared