磁共振DWI及DCE序列对早期强直性脊柱炎临床疗效评价的应用研究  

Application of diffusion-weighted imaging and dynamic contrast-enhanced magnetic resonance imaging sequences for evaluation of clinical outcome in early ankylosing spondylitis

作　　者：秦健[1] 张岳[1] 朱建忠[1] 李筱倩[1] 王梅[1] 李长勤[1] 

机构地区：[1]泰山医学院附属医院影像科,山东泰安271000

出　　处：《中国矫形外科杂志》2015年第7期594-599,共6页Orthopedic Journal of China

基　　金：山东省卫生厅医药卫生科技发展计划项目(编号:2013WS0325)

摘　　要：[目的]探讨磁共振DWI、DCE序列对评价中西医结合治疗早期强直性脊柱炎疗效的应用价值。[方法]随访前期研究中的48例(男38例、女10例)确诊为早期AS并经中西医治疗的患者,通过磁共振DWI及DCE扫描,获取治疗后关节面下骨髓ADC平均值,绘制TIC曲线,计算Fenh、Senh值及达峰时间Tmax值,与前期研究所获取治疗前相应数据进行统计学分析比对。[结果]经临床治疗的患者骶髂关节面下骨髓区ADC平均值:髂骨侧为(4.34±0.55)×10-4mm2/s,骶骨侧为(3.96±0.23)×10-4mm2/s,均较治疗前减低,组间差距具有显著统计学意义。半定量指标Fenh、Senh均较对照组明显减低,Tmax高于对照组,差异具有统计学意义。骶髂关节骶、髂侧ADC值与Fenh值间呈高度正相关关系(P<0.05),髂侧ADC值与Senh呈高度正相关关系(P<0.05)。[结论]磁共振DWI及DCE序列可用于评价AS炎症活动程度变化,反映早期AS患者的治疗疗效,并可为临床疗效提供可靠的影像学依据。[Objective] To investigate the efficacy of combination therapy for early ankylosing spondylitis（ AS） by using diffusion-weighted imaging（ DWI） and dynamic contrast-enhanced（ DCE） magnetic resonance imaging（ MRI） sequences.[Methods] MRI was used to evaluate the sacroiliac joint in 48 patients（ 38 men and 10 women） diagnosed with early AS who were treated with a combination of Chinese and Western medicine. The apparent diffusion coefficient（ ADC） value based on DWI and the time-intensity curve（ TIC） based on DCE were measured,and the relationships between the ADC values and the Fenh,Senh,and time to peak（ Tmax） values were analyzed. Statistical analysis was performed to compare the values to those measured at the previous corresponding institute. [Results] The average ADC of the sacroiliac joint articular surface of the bone marrow area of the patients after clinical treatment were（ 4. 34 ± 0. 55） × 10-4mm2/ s for the ilium side and（ 3. 96 ±0. 23） × 10-4mm2/ s for the sacral side. These values were lower than those measured before treatment,with a statistically significant difference observed between groups. The Fenh and Senh values were significantly lower in the treatment group than in the control group,whereas the Tmax was higher. In the evaluation of the sacroiliac joint,the Fenh and ADC values were positively correlated on the sacroiliac side（ P〈0. 05）,whereas the Senh and ADC values were highly positively correlated on the iliac side（ P〈0. 05）. [Conclusion] DWI and DCE MRI sequences can be used in AS patients to evaluate the changes in the degree of inflammatory activity and the efficacy of treatments at an early stage; further,these techniques can provide a reliable imaging basis for determining the clinical curative effect of AS treatments.

关 键 词：磁共振 弥散加权成像 磁共振动态增强扫描 强直性脊柱炎 疗效 

分 类 号：R593.23[医药卫生—内科学] R445.2[医药卫生—临床医学]