磁共振DWI联合DCE序列诊断早期强直性脊柱炎骶髂关节改变  

Clinical application of diffuse-weighted imaging and dynamic contrast-enhanced MRI in the diagnosis of early ankylosing spondylitis at sacroiliac joint

作　　者：李筱倩[1] 朱建忠[1] 赵鲁平[1] 秦健[1] 李长勤[1] 

机构地区：[1]泰山医学院附属医院影像中心,山东271000

出　　处：《放射学实践》2015年第6期679-682,共4页Radiologic Practice

摘　　要：目的:探讨磁共振DWI联合DCE-MRI诊断早期强直性脊柱炎的临床应用价值。方法:回顾性搜集48例临床早期活动性强直性脊柱炎患者影像资料,分析其DWI及DCE序列图像,分别测量骶侧髂侧关节面下骨髓的ADC值,并与21例健康志愿者的资料进行对比分析,计算增强因子Fenh、增强斜率Senh和达峰时间Tmax,并与正常组对照,绘制病例组时间-信号曲线(TIC),对ADC值与Fenh、Senh值之间关系进行统计学分析。结果:病例组髂骨侧关节面下骨髓区ADC平均值为(5.05±1.10)×10-4 mm2/s,骶骨侧为(4.63±0.79)×10-4 mm2/s,均较对照组增高;病例组骨髓区Fenh、Senh高于对照组,Tmax低于正常值;病例组TIC表现为Ⅱ型,Ⅲ型;病变区ADC值与Fenh值之间呈高度直线相关关系(P<0.05),相关系数r=0.705。结论:磁共振DWI及DCE-MRI对早期AS患者骶髂关节骨髓异常改变显示敏感;病变区ADC值与Fenh值相结合,增强了早期诊断本病的信心,提供了影像诊断的新思路。Objective：To investigate the clinical application of diffusion-weighted imaging（DWI）and dynamic contrast-enhanced MRI（DCE-MRI）in the diagnosis of early ankylosing spondylitis（AS）at sacroiliac joint.Methods：MR image data of 48 patients with early active AS was retrospectively reviewed.Based on DWI,the ADC values of bone marrow under the articular surface were measured and compared with those of 21 healthy volunteers（control group）.In addition,the time-intensity curve（TIC）was obtained from DCE-MRI.The factor of enhancement（Fenh）,slope of enhancement（Senh）and peak time（Tmax）were then calculated and compared with the control group.The relationships among ADC,Fenh and Senh were statistically analyzed.Results：In the patients＇ group,the mean ADC values were（5.05±1.10）×10^-4 mm^2/s on the iliac side and（4.63±0.79）×10^-4 mm^2/s on the sacral side,which were higher than those in the control group.Moreover,the Fenh and Senh values of the marrow area were also higher than those in the control group;however,the Tmax was lower in the patients＇ group than the control group.The ADC and Fenh values in the affected area showed highly linear correlation（r=0.705,P〈0.05）.Conclusion：DWI and DCE-MRI are sensitive to the abnormal changes of sacroiliac joints in the early ankylosing spondylitis.The combination of the ADC and Fenh provides us more confidence in early diagnosing AS.

关 键 词：磁共振成像 骶髂关节 脊柱炎 强直性 

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