表观扩散系数值在强直性脊柱炎患者髋关节活动性病变临床评价中的应用  

Clinical applications of apparent diffusion coefficient value for evaluation of hip joint of ankylosing spondylitis active lesions

作　　者：陈焱君[1] 赵英华[1] 陈芳妮[1] 孙尔维[1] 张鑫涛[1] 严杰文[1] 何懿[1] 李绍林[1] 

机构地区：[1]南方医科大学第三附属医院广东省骨科研究院影像科,广州510630

出　　处：《中华医学杂志》2015年第45期3646-3649,共4页National Medical Journal of China

基　　金：广东省公益研究与能力建设科技项目（2014A411308138117）

摘　　要：目的探讨MR表观扩散系数（AI）C）值对于强直性脊柱炎（AS）患者髋关节活动性病变的鉴别诊断价值。方法回顾分析2010年3月至2014年12月南方医科大学第三附属医院临床确诊的AS患者68例，其中活动期38例、稳定期30例，所有患者均行双侧髋关节MR扩散加权成像（DWI）检查并测量ADC值，运用统计学比较分析，比较不同病变状态患者病灶ADC值的差异。结果共检测髋关节238个病灶，表现为DWI和ADC图高信号，AS活动期和AS稳定期病灶ADC值分别为（1．00±0．13）×10^-3mm^2／s和（0．65±0．12）×10^-3mm^3／s，差异有统计学意义（t=-11．85，P=0．00）。ADC值与BASDAI评分相关系数为0．831（P〈0．01）。ROC曲线上ADC值最佳诊断阈值为0．81×10^-3mm^2／s，此时诊断为As活动期的敏感度、特异度分别为94．7％和90％。结论As患者测量髋关节病灶ADC值有助于评价强直性脊柱炎髋关节病变状态。Objective To evaluate the apparent diffusion coefficient （ADC） value in differential diagnosis of ankylosing spondylitis active lesions. Method A total of 68 patients with AS involving hip joint who were diagnosed in Third Affiliated Hospital of Southern Medical University form March 2010 to December 2014 were evaluated by MRI. The ADC values of the hip joint lesions were measured and compared in 38 cases of ankylosing spondylitis active lesions （ active group） and 30 cases of ankylosing spondylitis in stable period （stable group）, all cases were confirmed by clinical diagnosis. Results There are 238 lesions were detected demonstrating hyperintens in DWI and ADC picture. The mean ADC values of active group and stable group were（ 1.00± 0. 13 ） × 10-3 mma/s and （0. 65 ± 0. 12） ×10 3 mm2/s （t = - 11.85 ,P = 0. 00）. The correlation coefficient between ADC and BASDAI score is 0. 831 （ P 〈 0. 01 ）. ROC curve showed that the threshold ADC value differentiating active group and stable group was 0. 81 × 10 -3 mm2/s, with a sensitivity of 94. 7% and specificity of 90%. Conclusion The ADC value of hip joint lesion of AS patient can help to determine the nature of the ankylosing spondylitis.

关 键 词：脊柱炎 强直性 磁共振成像 磁共振成像 弥散 髋关节 

分 类 号：R593.23[医药卫生—内科学]