体素内不相干运动扩散加权成像诊断强直性脊柱炎活动性骶髂关节炎的价值  

The evaluation of active sacroiliitis in ankylosing spondylitis with intravoxel incoherent motion diffusion weighted imaging

作　　者：杨陈[1,2] 郭达 刘艳[1] 敬宗林[1] YANG Chen;GUO Da;LIU Yan(The Affiliated Hospital of Chuanbei Medical College,Sichuan 637000,China)

机构地区：[1]川北医学院附属医院,四川637000 [2]成都市第三人民医院

出　　处：《放射学实践》2018年第10期1057-1062,共6页Radiologic Practice

摘　　要：目的:探讨体素内不相干运动扩散加权成像(IVIM-DWI)在诊断强直性脊柱炎(AS)活动性骶髂关节炎中的价值。方法:根据ESR、CRP、Bath强直性脊柱炎病情活动指数(BASDAI)评分将符合纳入标准的49例AS患者分为活动期组(21例)和稳定期组(28例)。对照组为28名健康志愿者。分析对比3组间MRI图像、IVIM-DWI相关参数,采用单因素方差分析3组间纯水分子扩散系数(D),灌注相关的伪扩散系数(D*)以及灌注分数(f)。采用Mann-Whitney U检验分析稳定组及活动组间的年龄、BASDAI评分、ESR及CRP。绘制ROC曲线,比较各参数值的曲线下面积以评定其诊断效能。结果:稳定组及活动组间的年龄差异无统计学意义(P>0.05),活动组BASDAI评分、ESR及CRP高于稳定组,差异有统计学意义(P<0.05)。三组间D值差异有统计学意义(P<0.05)。活动组D*值高于稳定组、对照组,且差异有统计学意义(P<0.05);稳定组与对照组间D*值差异无统计学意义(P>0.05)。活动组f值高于稳定组、对照组,且差异有统计学意义(P<0.05);稳定组与对照组间D*值差异无统计学意义(P>0.05)。对比3个参数在各组间的ROC曲线下面积,其中D值的曲线下面积(AUC)最大,其敏感度及特异度最高。活动组与稳定组间D值的临界值为0.42×10-3 mm2/s(AUC0.870、敏感度83.8%、特异度74.8%),活动组与对照组间D值临界值为0.38×10-3 mm2/s(AUC0.923、敏感度89.2%、特异度85.3%)。结论:IVIM-DWI对AS骶髂关节炎活动性的诊断具有可行性,其中D值是最具有价值的参数。Objective:To explore the value of intravoxel incoherent motion diffusion-weighted imaging(IVIM-DWI)in evaluating the active sacroiliitis in ankylosing spondylitis(AS).Methods:49 patients with AS who met the inclusion criteria were divided into active group(21 cases)and stable group(28 cases)according to ESR,CRP and bath ankylosing spondylitis disease activity index(BASDAI)score.28 healthy volunteers were selected as the control group.MRI images and IVIM-DWI parameters of three groups were compared.The diffusion coefficient(D),the pseudo-diffusion coefficient(D*)and the perfusion fraction(f)of three groups were analyzed by one-way ANOVA.The ages,BASDAI scores,ESR and CRP of the stable and active groups were analyzed by Mann-Whitney U test.The receiver operating characteristic(ROC)curve was used to evaluate the value of above parameters in evaluation the activity of sacroiliitis in AS.Results:There was no significant difference in the age between the stable group and the active group(P>0.05).BASDAI scores,ESR and CRP of activity group were higher than the stable group(P<0.05).There was statistically significant of D value among the three groups(P<0.05).D*value of active group was higher than that of the stable group and the control group(P<0.05).There was no significant difference of D*value between stable group and control group(P>0.05).The f value of active group was higher than the stable group and the control group(P<0.05).There was no significant difference of f value between stable group and control group(P>0.05).Compared the area under the ROC curve(AUC)of three parameters among groups,the AUC of D value was largest and the sensitivity and specificity of D value were highest.The critical D value between active group and stable group was 0.42×10-3 mm 2/s(AUC 0.870,sensitivity 83.8%,specificity 74.8%).The critical D value between active group and control group was 0.38×10-3 mm 2/s(AUC 0.923,sensitivity 89.2%,specificity 85.3%).Conclusion:IVIM-DWI is feasible for the evaluation of the activity of sacroiliac a

关 键 词：脊柱炎 强直性 骶髂关节炎 活动性 磁共振成像 

分 类 号：R593.23[医药卫生—内科学] R684.3[医药卫生—临床医学]