Diagnostic Value Of Ultrasound For Sacroiliac Arthritis In Axial Spondyloarthropathy

Objective Axial spondyloarthropathy(axSpA)includes ankylosing spondylitis(AS)and non-radiographic axial spondyloarthritis(nr-axSpA),usually involving the sacroiliac joints(SIJs)at an earlier stage.The general data and laboratory examination indexes of AS patients and nr-axSpA patients were compared,and ultrasound was applied to examine the blood flow in the sacroiliac joints of both groups,and compared with MRI findings to assess the diagnostic value of ultrasound for sacroiliac arthritis in axSpA patients.And ultrasound was applied to follow up the changes of blood flow in the sacroiliac joint area after treatment in patients with active axSpA to explore the value of ultrasound for monitoring the efficacy assessment of active sacroiliac arthritis.Methods A total of 166 patients with axSpA were collected,including 102 patients(204joints)in the AS group and 64 patients(128 joints)in the nr-axSpA group,and all included patients underwent general data collection,relevant serological examinations,MRI and ultrasonography of the sacroiliac joints,and assessment of disease activity using the ankylosing spondylitis disease activity index(BASDAI).The ankylosing spondylitis diseasectivity index(BASDAI)was used to assess disease activity.According to the MRI results,patients with AS and nr-axSpA were divided into active and inactive groups,respectively,to compare the blood flow in the sacroiliac joint shown by ultrasound,and to compare the diagnostic value of ultrasound and MRI for active inflammation of the sacroiliac joint;then patients with axSpA with BASDAI score ≥4 were followed up by ultrasound,and their sacroiliac joints were retested by ultrasound after the disease was controlled after treatment,and the observation The difference between the relevant indexes before and after treatment was analyzed to evaluate the value of ultrasound monitoring of axSpA efficacy.The data were analyzed using the statistical software SPSS26.0,and P < 0.05 indicated that the difference was statistically significant.Results(1)The difference in HLA-27 positivity between the AS and nr-axSpA groups was not statistically significant(P=0.572),and the male morbidity,mean age at onset,duration of onset,BASDAI score,and inflammatory indexes were greater in the AS group than in the nr-axSpA group,with statistically significant differences(P<0.05).(2)The rate of blood flow signal display and blood flow abundance in the AS group were greater than those in the nr-axSpA group,and the RI value was lower than that in the nraxSpA group,and the differences in these three aspects were not statistically significant(P>0.05).(3)There were 60 active sacroiliac arthritis and 56 inactive sacroiliac joints in the nraxSpA group,and 118 active sacroiliac arthritis and 86 inactive sacroiliac arthritis in the AS group.Regardless of the nr-axSpA group or AS group,the active sacroiliac joints showed a higher rate of blood flow,exhibiting abundant blood flow and a lower RI value,and the difference was statistically significant compared with the inactive group(P <0.05).(4)The ROC for diagnosing active inflammation of sacroiliac joint in AS patients with RI value,the best cut-off value was 0.755,the area under the curve was 0.770,the sensitivity was 74.5%,the specificity was 67.0%,and the diagnostic agreement rate was 71.7%,which had better agreement compared with MRI(K=0.615,P<0.05).(5)The differences in blood flow display rate and abundance in the sacroiliac joint before and after treatment in patients with axSpA with BASIAD score ≥4 were not statistically significant(P>0.05),but the RI values increased significantly after treatment(P<0.05).Conclusion AS and nr-axSpA have similar genetic susceptibility,symptoms,and ultrasound manifestations of the sacroiliac joint,but AS has a longer age of onset and a more severe inflammatory response,and it can be assumed that nr-axSpA progresses to AS later.ultrasound-indicated abnormal blood flow is an important reference for the diagnosis of active inflammation,and the RI value can be a valuable quantitative indicator,compared with MRI.The two are in better agreement.The RI value of blood flow can be used to monitor the efficacy of axSpA,while the flow display rate and flow abundance are not significant.