动态对比增强MRI判断强直性脊柱炎骶髂关节炎活动性的临床初步研究  

Preliminary clinical study of sacroiliac activity in ankylosing spondylitis patients using quantitative dynamic contrast enhanced MRI

作　　者：初广宇 张孟超[1] 杨海山[1] 黄宁 柳林[1] 

机构地区：[1]吉林大学中日联谊医院放射科,长春130033 [2]GE医疗中国

出　　处：《中华放射学杂志》2015年第12期895-899,共5页Chinese Journal of Radiology

摘　　要：目的探讨动态对比增强（DCE）-MRI是否可判断强直性脊柱炎骶髂关节炎的活动性。方法根据1984年修订的强直性脊柱炎的诊断标准，明确诊断为强直性脊柱炎的患者42例，行DCE—MRI检查。根据红细胞沉降率、C反应蛋白和巴斯强直性脊柱炎疾病活动度指数评分（BASDAI）将患者分为静止期组和活动期组。分别对2组患者的MRI图像及数据进行阅片、分析，使用双室Tofts模型测定相应DCE-MRI定量参数，包括对比剂从血管到组织间隙的渗透率（K^trans）、细胞外间隙容积与血管内容积比（Kep）、细胞外间隙容积（Ve）、血管内容积（Vp）。对2组间的定量参数应用秩和检验进行比较。对两组间有差异的指标，采用Spearman分别同BASDAI评分进行相关性分析。结果骶髂关节炎活动期组患者22例（男18例、女4例）、静止期组20例（男18例、女2例）。活动期组和静止期组的K^trans、Kep、Ve分别为（0．750±1．130）／min、（1．008±0．732）／min、0．460±1．735；（0．163±0．401）／min、（0．505±0．902）／min、0．345±3．460，活动期的K^trans、Kep、Ve指标值显著高于静止期组（Z值分别为3．727、2．317、3．696，P值均〈0．05）。Vp值活动期组为0．125±0．310，静止期组为0．160±0．329，差异无统计学意义（Z=1．209，P〉0．05）。K^trans、Kep、Ve与BASDAI评分存在相关性，相关系数分别为0．714、0．430、0．676（P值均〈0．05）。结论DCE-MRI定量参数能够判断强直性脊柱炎骶髂关节炎的活动性，同时K^trans、Kep、Ve定量参数和BASDAI评分具有相关性。Objective To investigate the diagnostic values of DCE-MRI quantitative evaluation of the activity of sacroiliac joints in ankylosing spondylitis. Methods Forty two patients （36 male and 6 female） with ankylosing spondylitis in our hospital were enrolled prospectively according to the standard of diagnostic criteria for ankylosing spondylitis revised in 1984. All of them were evaluated with the blood sedimentation, C-reactive protein and ankylosing spondylitis activity index （BASDAI）. We divided the patients with ankylosing spondylitis into stationary phase group and active phase group. We analyzed each of the MRI images of the two patients groups using the extended Toffs model to determine the quantitative parameters of DCE-MRI, such as contrast transfer coefficient （K^trans）, reflux constant （Kep）, extravascular extracellular volume fraction （Ve）, plasma volume fraction （Vp）. And then the differences of quantitative data between the two groups were compared. Spearman correlation analysis was performed between the parameters with statistically significant difference and BASDAI scores. Results Among the 42 patients, 22 patients （18 male and 4 female） were in active phase group and the other 20 patients （18 male and 2 female） were in stationary phase group. K^trans, Kep, Ve were （0.750± 1.130）/min, （1.008＋0.732）/min, 0.460±1.735; （0.163 ±0.401）/rain, （0.505±0.902）/min, 0.345 ±3.460 for active phase group and the stationary phase group, respectively. The results of the active phase group was significantly higher than the stationary phase group （Z=3.727, 2.317, 3.696, respectively;all P〈0.05）. The Vp had no statistically significance for the active phase group （0.125 ±0.310） and the stationary phase group （0.160 ±0.329） （Z=1.209, P〉0.05）. Strong correlations existed between K^trans, Kep, Ve and BASDAI score, the correlation coefficients were 0.714, 0.430, and 0.676 （P〈0.05）. Conclusions Quantitative DCE-MRI parameters can evaluate the

关 键 词：脊柱炎 强直性 磁共振成像 骶髂关节炎 

分 类 号：R445.2[医药卫生—影像医学与核医学] R593.23[医药卫生—诊断学]