FRACTURE序列在中轴型脊柱关节炎骶髂关节结构性病变中的诊断价值  

The diagnostic value of FRACTURE sequence in structural lesions of the sacroiliac joint in axial spondyloarthritis

作　　者：章忆惠 程艺璇 徐磊[2] 徐凌霄[3] 谈文峰[3] 王梦悦 祁良[2] ZHANG Yi-hui;CHENG Yi-xuan;XU Lei(Department of Radiology,the First Affiliated Hospital of Nanjing Medical University,Nanjing 210029,China)

机构地区：[1]南京医科大学,南京210029 [2]南京医科大学第一附属医院放射科 [3]南京医科大学第一附属医院风湿免疫科

出　　处：《放射学实践》2024年第7期929-934,共6页Radiologic Practice

摘　　要：目的:评估限制回波间隔的快速梯度回波类CT成像(FRACTURE)序列在检测中轴型脊柱关节炎(SpA)骶髂关节结构病变中的诊断价值。方法:回顾性分析83例确诊中轴型SpA患者在2021年12月-2022年8月进行骶髂关节MRI和CT检查的影像资料。评估图像包括FRACTURE、T_(1)WI序列和CT平扫图像。对骶髂关节的影像图像进行结构性病变评分:关节间隙变化(0~5分)、骨质侵蚀(0~3分)和骨质硬化(0~2分)。根据修改后的纽约标准评分系统对骶髂关节炎进行综合评分。结果:总共有166个骶髂关节图像(83名受试者)可供分析。以CT图像作为参考标准,FRACTURE序列在关节间隙改变、骨质侵蚀、骨质硬化和骶髂关节炎综合评分与CT结果表现出较高的一致性,AUC分别为0.908、0.943、0.918和0.944。与T_(1)WI相比,FRACTURE在关节间隙变化(91.8%vs.70.5%)、骨质侵蚀(93.3%vs.56.4%)、骨质硬化(94%vs.77.6%)和骶髂关节炎综合评分(98.9%vs.75.3%)方面具有更高的诊断准确性。结论:FRACTURE成像可以评估中轴型SpA患者骶髂关节的结构性病变,并显示出良好的诊断性能。Objective:To assess the diagnostic performance of FRACTURE(fast field echo resembling a CT using restricted echo-spacing) sequence in detecting structure lesions of the sacroiliac joint(SIJ) in axial spondyloarthritis(SpA).Methods:The imaging data of 83 confirmed patients with axial SpA who underwent sacroiliac joint MRI and CT examinations during the period from 2021 to 2022 were retrospectively analyzed.Images of FRACTURE and T_(1)WI sequence of MRI and CT scan of the SIJ were assessed at the same time.The image of SIJ were scored for structural lesions,including joint space changes(score 0~5),subchondral erosions(score 0~3) and subchondral sclerosis(score 0~2).A comprehensive score of sacroiliitis was also provided according to the scoring system of the modified New York criteria.Results:In total,166 SIJ(83 participants) were available for analysis.Using the CT as the standard,FRACTURE showed a high agreement with an AUC of 0.908,0.943,0.918 and 0.944 in joint space changes,subchondral erosions,subchondral sclerosis and comprehensive scores of sacroiliitis.Diagnostic accuracy of FRACTURE was higher than that of T_(1)WI for joint space changes(91.8% vs.70.5%),subchondral erosions(93.3% vs.56.4%),subchondral sclerosis(94% vs.77.6%),and comprehensive scores of sacroiliitis(98.9% vs.75.3%).Conclusion:FRACTURE imaging of MRI can evaluate structural lesions and show good diagnostic performance of the sacroiliac joint in patients with SpA.

关 键 词：FRACTURE序列 骶髂关节 脊柱关节病 磁共振成像 体层摄影术 X线计算机 

分 类 号：R814.42[医药卫生—影像医学与核医学] R684[医药卫生—放射医学]