Correlation of histopathological findings and magnetic resonance imaging in the spine of patients with ankylosing spondylitis
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Correlation of histopathological findings and magnetic resonance imaging in the spine of patients with ankylosing spondylitis. / Appel, Heiner; Loddenkemper, Christoph; Grozdanovic, Zarko; Ebhardt, Harald; Dreimann, Marc; Hempfing, Axel; Stein, Harald; Metz-Stavenhagen, Peter; Rudwaleit, Martin; Sieper, Joachim.
In: ARTHRITIS RES THER, Vol. 8, No. 5, 01.01.2006, p. R143.Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review
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TY - JOUR
T1 - Correlation of histopathological findings and magnetic resonance imaging in the spine of patients with ankylosing spondylitis
AU - Appel, Heiner
AU - Loddenkemper, Christoph
AU - Grozdanovic, Zarko
AU - Ebhardt, Harald
AU - Dreimann, Marc
AU - Hempfing, Axel
AU - Stein, Harald
AU - Metz-Stavenhagen, Peter
AU - Rudwaleit, Martin
AU - Sieper, Joachim
PY - 2006/1/1
Y1 - 2006/1/1
N2 - Ankylosing spondylitis (AS) is a chronic inflammatory disease which affects primarily the sacroiliac joints and the spine. In patients with active disease, magnetic resonance imaging (MRI) of the spine shows areas of bone marrow edema, the histopathological equivalent of which is unknown. In this study we correlate inflammation in the spine of patients with AS as revealed by histological examination with bone marrow edema as detected by MRI. We have compared the histopathological findings of zygapophyseal joints from 8 patients with AS (age: 30 to 64, disease duration 7 to 33 years) undergoing spinal surgery with findings in MRI. For histopathological analysis, we quantified infiltrates of CD3+, CD4+ and CD8+ T cells as well as CD20+ B cells immunohistochemically. Bone marrow edema was evaluated in hematoxylin and eosin stained sections and quantified as the percentage of the bone marrow area involved. All patients with AS showed interstitial mononuclear cell infiltrates and various degrees of bone marrow edema (range from 10% to 60%) in histopathological analysis. However, in only three of eight patients histopathological inflammation and edema in the zygapophyseal joints correlated with bone marrow edema in zygapophyseal joints of the lumbar spine as detected by MRI. Interestingly, two of these patients showed the highest histological score for bone marrow edema (60%). This first study correlating histopathological changes in the spine of patients with AS with findings in MRI scans suggests that a substantial degree of bone marrow inflammation and edema is necessary to be detected by MRI.
AB - Ankylosing spondylitis (AS) is a chronic inflammatory disease which affects primarily the sacroiliac joints and the spine. In patients with active disease, magnetic resonance imaging (MRI) of the spine shows areas of bone marrow edema, the histopathological equivalent of which is unknown. In this study we correlate inflammation in the spine of patients with AS as revealed by histological examination with bone marrow edema as detected by MRI. We have compared the histopathological findings of zygapophyseal joints from 8 patients with AS (age: 30 to 64, disease duration 7 to 33 years) undergoing spinal surgery with findings in MRI. For histopathological analysis, we quantified infiltrates of CD3+, CD4+ and CD8+ T cells as well as CD20+ B cells immunohistochemically. Bone marrow edema was evaluated in hematoxylin and eosin stained sections and quantified as the percentage of the bone marrow area involved. All patients with AS showed interstitial mononuclear cell infiltrates and various degrees of bone marrow edema (range from 10% to 60%) in histopathological analysis. However, in only three of eight patients histopathological inflammation and edema in the zygapophyseal joints correlated with bone marrow edema in zygapophyseal joints of the lumbar spine as detected by MRI. Interestingly, two of these patients showed the highest histological score for bone marrow edema (60%). This first study correlating histopathological changes in the spine of patients with AS with findings in MRI scans suggests that a substantial degree of bone marrow inflammation and edema is necessary to be detected by MRI.
KW - Adult
KW - Antigens, CD20
KW - Antigens, CD3
KW - B-Lymphocytes
KW - Bone Marrow
KW - CD4-Positive T-Lymphocytes
KW - CD8-Positive T-Lymphocytes
KW - Edema
KW - Female
KW - Humans
KW - Immunohistochemistry
KW - Magnetic Resonance Imaging
KW - Male
KW - Microcirculation
KW - Middle Aged
KW - Spondylitis, Ankylosing
KW - Zygapophyseal Joint
U2 - 10.1186/ar2035
DO - 10.1186/ar2035
M3 - SCORING: Journal article
C2 - 16925803
VL - 8
SP - R143
JO - ARTHRITIS RES THER
JF - ARTHRITIS RES THER
SN - 1478-6354
IS - 5
ER -