摘要
目的探讨动态对比增强磁共振成像（DCE-MRI）在糖尿病足（DF）骨髓炎中的应用价值及与血清检验指标C反应蛋白（CRP）及血沉（ESR）的相关性。方法搜集30例经临床综合诊断的DF骨髓炎患者的实验室血清检查、足部常规MRI和DCE-MRI检查资料。运用动态增强血流动力学软件测量足部骨髓炎及非骨髓炎区DCE定量参数值,包括容积转移常数（K^trans）、血管外细胞外间隙容积分数（Ve）、速率常数（K（ep））。采用t检验比较分析骨髓炎及非骨髓炎区各参数的差异,并与血清学检查各指标之间进行相关性分析。采用受试者工作特征曲线（ROC）分析K^trans、K（ep）、Ve对于骨髓炎及非骨髓炎区的鉴别能力。结果骨髓炎区定量参数K^trans、K（ep）、Ve值分别为（0.819±1.172）min^-1、（1.191±0.853）min^-1、0.483±0.328。DF患者骨髓炎区定量参数K^trans、K（ep）、Ve值明显高于非骨髓炎区。Pearson相关分析显示DF患者骨髓炎区域灌注参数K^trans、K（ep）、Ve与CRP及ESR呈正相关。ROC显示K^trans、Ve值对DF骨髓炎的鉴别诊断效能高于K（ep）值。结论 DCE-MRI定量参数可以评价DF骨髓炎的严重程度,对于临床监测疗效及评估预后具有重要价值。
Objective To investigate the application value of dynamic contrast-enhanced magnetic resonance imaging（ DCE-MRI） in diabetic foot osteomyelitis and its correlation with clinical laboratory examination CRP and ESR. Methods Thirty patients with the comprehensive clinical diagnosis of DF osteomyelitis underwent laboratory examination,conventional MRI and DCE-MRI. Quantitative parameters including the volume transfer constant（ K^trans）,rate constant（ K（ep））,extravascular extracellular volume fraction（ Ve） of diabetic foot osteomyelitis regions and non-osteomyelitis regions were derived from DCE-MRI data,quantitative parameters between the two regions were analyzed by using Student t test. The Relationship between quantitative parameters and ESR and CRP were analyzed by using correlation analysis. We also used the the receiver operating characteristic curve to analyse the identification ability of K^trans、K（ep）、Ve in osteomyelitis and non-osteomyelitis regions. Results The quantitative parameters K^trans、K（ep）,and Ve of the osteomyelitis regions were（ 0. 819 ±1. 172） ml/min,（ 1. 191 ± 0. 853） ml/min,（ 0. 483 ± 0. 328） ml/min,（ 0. 101 ± 0. 054） ml/min respectively. The quantitative parameters in osteomyelitis regions were significantly higher than that in non-osteomyelitis region. Pearson correlation analysis showed that K^trans、K（ep）、Ve were correlated with CRP and ESR. The ROC analysis showed that K^transand Ve are better than K（ep）for the diagnosis of diabetic foot osteomyelitis. Conclusion The parameters of DCE-MRI can quantitatively evaluate the degree of inflammation of osteomyelitis in the diabetic foot,and it has great value in monitoring and evaluating the disease prognosis.
作者
廖旦
谢利秋
张志伟
罗琦
李咏梅
LIAO Dan;XIE Liqiu;ZHANG Zhiwei(Department of Radiology,the First Affiliated Hospital of Chongqing Medical University,Chongqing 400016,P.R.China)
出处
《临床放射学杂志》
CSCD
北大核心
2018年第8期1347-1351,共5页
Journal of Clinical Radiology
基金
国家临床重点专科建设项目([2013]544)
关键词
磁共振成像
骨髓炎
动态增强
糖尿病足
Magnetic resonance imaging
Osteomyelitis
Dynamic enhancement
Diabetic foot
