摘要
目的探讨弥散加权成像(DWI)判断强直性脊柱炎(AS)骶髂关节炎活动性的临床应用价值。方法前瞻性收集73例AS患者,根据AS病情活动指数(BASDAI)调查表、实验室检查结果将AS患者分为活动组43例和稳定组30例,所有患者均行双侧骶髂关节常规磁共振成像及DWI检查,由2名放射诊断医师独立测量骶髂关节面下病变区的表观弥散系数(ADC),并计算相对ADC (r ADC)值,比较活动组及稳定组ADC值及r ADC值的差异,分析ADC值及r ADC值鉴别骶髂关节炎活动性的效能,此外,分别计算ADC值、r ADC值与BASDAI的相关系数。结果活动组ADC值、r ADC值分别为(0. 667±0. 122)×10^(-3)mm^2/s、(1. 715±0. 343)×10^(-3)mm^2/s,显著高于稳定组的(0. 492±0. 0651)×10^(-3)mm^2/s、(1. 289±0. 209)×10^(-3)mm^2/s (P <0. 0001)。2名医师测量结果的一致性较好,组内相关系数均大于0. 81。ADC值、r ADC值与BASDAI评分相关系数分别为0. 82、0. 80 (P <0. 0001)。ADC值、r ADC值判断AS活动性的最佳阈值分别为0. 545×10^(-3)mm^2/s、1. 467×10^(-3)mm^2/s,特异度均为81. 8%,敏感度分别为92. 0%、88. 0%。结论 DWI有助于定量评价AS患者骶髂关节炎的活动性。
Objective To investigate the clinical value of diffusion-weighted imaging(DWI)for evaluating the activity of sacroiliitis in ankylosing spondylitis(AS).Methods Totally 73 AS patients were prospectively enrolled and divided into active group(n=43)and chronic group(n=30)according to Bath ankylosing spondylitis disease activity index(BASDAI)scores and laboratory findings.Conventional magnetic resonance imaging(MRI)and DWI were performed in all subjects.Apparent diffusion coefficient(ADC)values of subchondral lesions in sacroiliac joint were independently measured by two radiologists,and the relative ADC(rADC)values were calculated.ADC and rADC values were compared between active and chronic groups.The efficiencies of ADC and rADC values for differentiating the activity of sacroiliitis were analyzed.In addition,the correlation coefficients of ADC values,rADC values,and BASDAI scores were calculated.Results The ADC and rADC values in the active group were(0.667±0.122)×10^-3 mm^2/s and(1.715±0.343)×10^-3 mm^2/s,respectively,which were significantly higher than those of the chronic group[(0.492±0.0651)×10^-3 mm^2/s and(1.289±0.209)×10^-3 mm^2/s,respectively)](P<0.0001).The agreement of measurement results between two radiologists was good,and all the interclass correlation coefficients were>0.81.The correlation coefficients of ADC value and rADC value with BASDAI scores were 0.82 and 0.80,respectively(P<0.0001).The optimal cutoff values of ADC value and rADC value for differentiating AS activity were 0.545×10^-3 mm^2/s and 1.467×10^-3 mm^2/s,respectively,The specificity was 81.8%for both indicators,and the sensitivity was 92.0%and 88.0%,respectively.Conclusion DWI is helpful in the quantitative assessment of the activity of sacroiliitis in AS patients.
作者
任翠
朱巧
陈雯
郎宁
袁慧书
REN Cui;ZHU Qiao;CHEN Wen;LANG Ning;YUAN Huishu(Department of Radiology,Peking University Third Hospital,Beijing 100191,China)
出处
《中国医学科学院学报》
CAS
CSCD
北大核心
2018年第6期723-729,共7页
Acta Academiae Medicinae Sinicae
基金
国家自然科学基金(81701648)~~
关键词
强直性脊柱炎
骶髂关节
活动性
弥散加权成像
ankylosing spondylitis
sacroiliac joint
activity
diffusion-weighted imaging
