Diffusion-Weighted Whole-Body Magnetic Resonance Imaging with Background Body Signal Suppression for Differentiating Infectious from Non-Infectious Aortitis.

Background/

Objectives

This study examined the clinical utility of diffusion-weighted whole-body magnetic resonance imaging with background body signal suppression (DWIBS) for differentiating infectious from non-infectious aortitis.

Methods

The study included 32 patients with suspected inflammatory aortitis who underwent non-contrast computed tomography (NCCT) and magnetic resonance imaging. We evaluated the diagnostic performance of DWIBS using the spinal cord as a reference, NCCT, and their combination. The diagnosis of infectious aortitis was adjudicated based on imaging, clinical, and laboratory findings. We conducted a sensitivity analysis using a stricter definition of infectious aortitis that required both surgical and microbiological confirmation.

Results

Fifteen patients were diagnosed with infectious aortitis. The sensitivity, specificity, and areas under the receiver operating characteristic curves were 93.3%, 70.6%, and 0.82, respectively, for NCCT; 93.3%, 76.5%, and 0.85, respectively, for DWIBS; and 86.7%, 94.1%, and 0.90, respectively, for the combination of both modalities. In the sensitivity analysis, the combined DWIBS and NCCT approach demonstrated a specificity of 87.5% and a sensitivity of 70.8%.

Conclusions

DWIBS using the spinal cord as a reference appears to be a promising diagnostic tool for differentiating infectious from non-infectious aortitis, especially when combined with NCCT.