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Clinical Article
A preliminary study on the efficacy of tumor necrosis factor alpha antagonists in the treatment of axial spondyloarthropathy by T1-mapping technique
YU Shun  SU Jiawei  LIN Mingui  CHEN Xianyuan  MA Mingping 

Cite this article as: Yu S, Su JW, Lin MG, et al. A preliminary study on the efficacy of tumor necrosis factor alpha antagonists in the treatment of axial spondyloarthropathy by T1-mapping technique[J]. Chin J Magn Reson Imaging, 2022, 13(1): 21-25, 36. DOI:10.12015/issn.1674-8034.2022.01.005.

[Abstract] Objective To explore the use of MRI T1-mapping technique to evaluate the efficacy of tumor necrosis factor-α antagonists in the treatment of axial spondyloarthropathy (axSpA), in order to provide effective quantitative indicators for the evaluation of axSpA treatment.Materials and Methods One hundred and fourteen study subjects were included, of which 15 normal sacroiliac joint subjects excluded from the diagnosis of axSpA were the control group, and 99 clinically confirmed axSpA patients were the case group, twenty patients in the case group were treated with systemic TNF-α antagonists as the treatment group. The case group was divided into active group and inactive group. The active group was divided into three subgroups: moderate activity group, high activity group and very high activity group. The treatment group was divided into pre-treatment group and 3 weeks treatment group, 6 weeks treatment group and 12 weeks treatment group according to the different time of treatment. All subjects underwent T1-mapping sequence examination to compare the differences in T1-mapping values of the sacroiliac joint subchondral bone marrow area between the control group, the case group, and the subgroups of the case group, using ROC curve to analyze the diagnostic efficacy and monitoring of therapeutic efficacy of different treatment cycles in the treatment group.Results (1) There was no significant difference in the T1-mapping value of the subchondral bone marrow area of the sacroiliac joint and iliac joint in each group, all P>0.05; (2) Compared with the control group, the T1-mapping value of the bone marrow area under the sacroiliac articular cartilage of the case group increased to varying degrees, T1-mapping value had a good diagnostic efficiency for the high activity group and the very high activity group; (3) The decrease rate of T1-mapping value in the subchondral bone marrow area of sacroiliac joint in different treatment cycles in the treatment group could effectively monitor the curative effect.Conclusions T1-mapping technology can quantitatively evaluate axSpA inflammatory activity, and effectively monitor the efficacy, which is beneficial to clinical individualized treatment and timely adjustment of treatment plans.
[Keywords] axial spondyloarthropathy;ankylosing spondylitis;tumor necrosis factor-α;T1-mapping;bone marrow edema

YU Shun*   SU Jiawei   LIN Mingui   CHEN Xianyuan   MA Mingping  

Shengli Clinical Medical College of Fujian Medical University, Department of Radiology of Fujian Provincial Hospital, Fuzhou 350001, China

Yu S, E-mail:

Conflicts of interest   None.

ACKNOWLEDGMENTS Natural Science Foundation of Fujian Provincet (No. 2017J01172); Sky imaging research fund development project of China International Medical Exchange Foundation (No. Z-2014-07-1912-14); Young and Middle-aged Key Personnel Training Project of Fujian Provincial Health Commission (No. 2020GGA005).
Received  2021-06-21
Accepted  2021-11-10
DOI: 10.12015/issn.1674-8034.2022.01.005
Cite this article as: Yu S, Su JW, Lin MG, et al. A preliminary study on the efficacy of tumor necrosis factor alpha antagonists in the treatment of axial spondyloarthropathy by T1-mapping technique[J]. Chin J Magn Reson Imaging, 2022, 13(1): 21-25, 36. DOI:10.12015/issn.1674-8034.2022.01.005.

Zeng QY, Chen R, Darmawan J, et al. Rheumatic diseases in China[J]. Arthritis Res Ther, 2008, 10(1): 1-11. DOI: 10.1186/ar2368.
Garrido-Cumbrera M, Bundy C, Navarro-Compán V, et al. Patient-reported Impact of Axial Spondyloarthritis on Working Life: Results from the EMAS survey[J]. Arthritis Care Res (Hoboken), 2020, 18(3): 220-225. DOI: 10.1002/acr.24426.
Machado P, Landewé R, Lie E, et al. Ankylosing Spondylitis Disease Activity Score (ASDAS): defining cut-off values for disease activity states and improvement scores[J]. Ann Rheum Dis, 2011, 70(1): 47-53. DOI: 10.1136/ard.2010.138594.
Prajzlerová K, Komarc M, Forejtová Š, et al. Circulating miR-145 as a marker of therapeutic response to anti-TNF therapy in patients with ankylosing spondylitis[J]. Physiol Res, 2021, 70(2): 255-264. DOI: 10.33549/physiolres.934542.
Rocha FAC, Pinto ACMD, Lopes JR, et al. Tumor necrosis factor inhibitors prevent structural damage in hips in ankylosing spondylitis-time to reconsider treatment guidelines? A case series and review of literature[J]. Clin Rheumatol, 2021, 40(5): 1881-1887. DOI: 10.1007/s10067-020-05519-0.
Lawson DO, Eraso M, Mbuagbaw L, et al. Tumor Necrosis Factor Inhibitor Dose Reduction for Axial Spondyloarthritis: A Systematic Review and Meta-Analysis of Randomized Controlled Trials[J]. Arthritis Care Res (Hoboken), 2021, 73(6): 861-872. DOI: 10.1002/acr.24184.
Shiguetomi-Medina JM, Ramirez-Gl JL, Stødkilde-Jørgensen H, et al. Systematized water content calculation in cartilage using T1-mapping MR estimations: design and validation of a mathematical model[J]. J Orthop Traumatol, 2017, 18(3): 217-220. DOI: 10.1007/s10195-016-0433-8.
Mittal S, Pradhan G, Singh S, et al. T1 and T2 mapping of articular cartilage and menisci in early osteoarthritis of the knee using 3-Tesla magnetic resonance imaging[J]. Pol J Radiol, 2019, 84(3): 549-564. DOI: 10.5114/pjr.2019.91375.
Rudwaleit M, van der Heijde D, Landewé R, et al. The development of Assessment of SpondyloArthritis international Society classification criteria for axial spondyloarthritis (part Ⅱ): validation and final selection[J]. Ann Rheum Dis, 2009, 68(6): 777-783. DOI: 10.1136/ard.2009.108233.
Van Der Heijde D, Ramiro S, Landewé R, et al. 2016 update of the ASAS-EULAR management recommendations for axial spondyloarthritis[J]. Ann Rheum Dis, 2017, 76(6): 978-991. DOI: 10.1136/annrheumdis-2016-210770.
Lin MG, Chen XY, Yu S, et al. RESOLVE diffusion weighted imaging in evaluation on sacroiliac joint active lesions caused by axial spondyloarthritis[J]. Chin J Med Imaging Technol, 2021, 37(4): 587-592. DOI: 10.13929/j.issn.1003-3289.2021.04.025.
Lin MG, Chen XY, Yu S, et al. Quantitative evaluation of sacroiliac arthritis activity in SpA based on DCE-MRI microvascular permeability parameters[J]. Chin J Magn Reson Imaging, 2021, 12(4): 39-44. DOI: 10.12015/issn.1674-8034.2021.04.008.
Tsang HHL, Wong CKH, Cheung PWH, et al. Responsiveness of the EuroQoL 5-Dimension (EQ-5D) questionnaire in patients with spondyloarthritis[J]. BMC Musculoskelet Disord, 2021, 22(1): 439. DOI: 10.1186/s12891-021-04315-4.
Ortolan A, Ramiro S, van Gaalen F, et al. Development and validation of an alternative ankylosing spondylitis disease activity score when patient global assessment is unavailable[J]. Rheumatology (Oxford), 2021, 60(2): 638-648. DOI: 10.1093/rheumatology/keaa241.
Ren C, Zhu Q, Yuan H. Imaging features of spinal fractures in ankylosing spondylitis and the diagnostic value of different imaging methods[J]. Quant Imaging Med Surg, 2021, 11(6): 2499-2508. DOI: 10.21037/qims-20-962.
Zilber K, Gorenberg M, Rimar D, et al. Radionuclide Methods in the Diagnosis of Sacroiliitis in Patients with Spondyloarthritis: An Update[J]. Rambam Maimonides Med J, 2016, 7(4): e0037. DOI: 10.5041/RMMJ.10264.
Zhu L, Chen P, Sun X, et al. Musculoskeletal ultrasound for ankylosing spondylitis: A systematic review and meta-analysis[J]. Medicine (Baltimore), 2021, 100(18): e25822. DOI: 10.1097/MD.0000000000025822.
Falsetti P, Conticini E, Mazzei MA, et al. Power and spectral Doppler ultrasound in suspected active sacroiliitis: a comparison with magnetic resonance imaging as gold standard[J]. Rheumatology (Oxford), 2021, 60(3): 1338-1345. DOI: 10.1093/rheumatology/keaa546.
Bainbridge A, Bray TJP, Sengupta R, et al. Practical Approaches to Bone Marrow Fat Fraction Quantification Across Magnetic Resonance Imaging Platforms[J]. J Magn Reson Imaging, 2020, 52(1): 298-306. DOI: 10.1002/jmri.27039.
Bray TJP, Sakai N, Dudek A, et al. Histographic analysis of oedema and fat in inflamed bone marrow based on quantitative MRI[J]. Eur Radiol, 2020, 30(9): 5099-5109. DOI: 10.1007/s00330-020-06785-x.
Yoneyama K, Kitanaka Y, Tanaka O, et al. Cardiovascular magnetic resonance imaging in heart failure[J]. Expert Rev Cardiovasc Ther, 2018, 16(4): 237-248. DOI: 10.1080/14779072.2018.1445525.
Lambert RG, Bakker PA, van der Heijde D, et al. Defining active sacroiliitis on MRI for classification of axial spondyloarthritis: update by the ASAS MRI working group[J]. Ann Rheum Dis, 2016, 75(11): 1958-1963. DOI: 10.1136/annrheumdis-2015-208642.
Tenório APM, Faleiros MC, Junior JRF, et al. A study of MRI-based radiomics biomarkers for sacroiliitis and spondyloarthritis[J]. Int J Comput Assist Radiol Surg, 2020, 15(10): 1737-1748. DOI: 10.1007/s11548-020-02219-7.

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