MRI集成序列在强直性脊柱炎骶髂关节病变活动性评估中的诊断价值  

Quantitative evaluation of sacroiliac arthritis activity in ankylosing spondylitis based on magnetic resonance image compilation sequences

作　　者：田兆荣[1] 张莉萍[1] 田博[1] 池淑红[2] 王晶 徐奋玲 王志军[1] 龚瑞[1] TIAN Zhaorong;ZHANG Liping;TIAN Bo;CHI Shuhong;WANG Jing;XU Fenling;WANG Zhijun;GONG Rui(Department of Radiology,General Hospital of Ningxia Medical University,Yinchuan 750001,China;Department of Rheumatology,General Hospital of Ningxia Medical University,Yinchuan 750001,China;Department of Radiology,Shizuishan Third People's Hospital,Shizuishan 750002,China;Ningxia medical university,Yinchuan 750001,China)

机构地区：[1]宁夏医科大学总医院放射科,银川750001 [2]宁夏医科大学总医院风湿科,银川750001 [3]宁夏石嘴山市第三人民医院放射科,石嘴山750002 [4]宁夏医科大学,银川750001

出　　处：《磁共振成像》2023年第12期78-84,共7页Chinese Journal of Magnetic Resonance Imaging

基　　金：宁夏回族自治区重点研发计划项目(编号:2021BEG03033)。

摘　　要：目的运用MRI集成(magnetic resonanceimage compilation,MAGiC)序列定量参数对强直性脊柱炎(ankylosing spondylitis,AS)骶髂关节改变进行量化评估,以期对AS骶髂关节炎症活动性评估提供量化指标;并评价MAGiC定量参数T1、T2和PD值与Bath强直性脊柱炎疾病活动指数(Bath Ankylosing Spondylitis Disease Activity Index,BASDAI)和加拿大脊柱关节炎研究联盟(Spondyloarthritis Research Consortium of Canada,SPARCC)评分的相关性。材料与方法回顾性分析78例AS合并骶髂关节炎患者病例和35例健康对照者资料。所有患者均进行轴位T1WI、脂肪抑制T2WI(fat-saturated T2WI,FS-T2WI)和MAGiC序列斜冠状位扫描。根据强直性脊柱炎疾病活动评分(Ankylosing Spondylitis Disease Activity Score,ASDAS)评分和C-反应蛋白(C-reactive protein,CRP)将患者分为活动组(40例)和非活动组(38例)。由两名放射科医师在MAGiC序列上测定活动组、非活动组和健康对照组骶髂关节软骨下骨髓的T1、T2和质子密度(proton density,PD)值。采用单因素方差分析对活动组、非活动组和健康对照组间T1、T2和PD值的平均值进行比较。采用受试者工作特征曲线(receiver operating characteristic,ROC)分析T1、T2和PD值对骶髂关节炎的诊断效能。采用Spearman相关性分析检验T1、T2、PD值与BASDAI和SPARCC评分的相关性。P<0.05为差异有统计学意义。结果AS活动组骶髂关节软骨下骨髓T1值[(531.04±60.28)ms]低于非活动组[(691.50±72.44)ms]和健康对照组[(933.23±100.98)ms],差异有统计学意义(t=-11.517,P<0.001);活动组T2值[(119.00±9.56)ms]、PD值[(86.03±14.79)pu]高于非活动组[(96.61±8.86)ms、(68.12±7.77)pu]和健康对照组[(78.94±6.20)ms、(53.71±6.69)pu];差异有统计学意义(t=-15.332、15.972,P均<0.001)。MAGiC定量参数T1、T2、PD值诊断AS活动性的ROC曲线下面积(area under the curve,AUC)分别为0.965(95%CI:0.949~0.991)、0.981(95%CI:0.970~0.998)、0.840(95%CI:0.842~0.923)。AS活动组�Objective:To explore the feasibility of using magnetic resonance image compilation(MAGiC)parameters to quantitatively evaluate changes of sacroiliac joint in ankylosing spondylitis(AS),in order to provide a quantitative index for the evaluation of sacroiliac joint inflammatory activity in AS.And to evaluate the correlations of T1,T2 and proton density(PD)values with Bath Ankylosing Spondylitis Disease Activity Index(BASDAI)and Spondyloarthritis Research Consortium of Canada(SPARCC)scores.Materials and Methods:A total of 78 AS patients with sacroiliitis and 35 healthy controls were enrolled.All patients were scanned using a GE SIGNATM Architect 3.0 T MRI scanner by T1WI,fat-saturated T2-weighted imaging(FS-T2WI)and MAGiC sequence of the sacroiliac joints.According to Ankylosing Spondylitis Disease Activity Score(ASDAS)scores and C-reactive protein(CRP),the 78 patients were divided into an active group(40 cases)and an inactive group(38 cases).The T1,T2 and PD values of the subchondral bone marrow were measured in the active group,the inactive group,and the healthy control group using the MAGiC sequence.The T1,T2 and PD values of the active,inactive,and healthy groups were compared using one-way analysis of variance(ANOVA).Receiver operating characteristic(ROC)curves were used to analyze the diagnostic efficacy of T1、T2 and PD values for sacroiliitis.The correlations of the T1,T2 and PD values with the BASDAI and SPARCC scores were analyzed using Spearman's rho.Results:The T1 values[(531.04±60.28)ms]in the active group were lower than those in the inactive group[(691.50±72.44)ms],and lower than those in the healthy control group[(933.23±100.98)ms],t=-11.517,P<0.001.T2 and PD values in the active group[(119.00±9.56)ms,(86.03±14.79)pu]were both higher than those in the inactive group[(96.61±8.86)ms,(68.12±7.77)pu],and higher than those in the healthy control group[(78.94±6.20)ms,(53.71±6.69)pu],t=-15.332,15.972,all P<0.001;the area under the ROC curve(AUC)of T1,T2 and PD values between the active and inacti

关 键 词：强直性脊柱炎 骶髂关节炎 磁共振成像 磁共振成像集成序列 活动性 

分 类 号：R445.2[医药卫生—影像医学与核医学] R681.51[医药卫生—诊断学]