DWI、DCE-MRI及3D-MEDIC-WE定量分析在评估强直性脊柱炎骶髂关节炎性改变中的应用研究  

Application of DWI,DCE-MRI and 3D-MEDICA-WE quantitative analysis in evaluating inflammatory changes of sacroiliac joints in patients with ankylosing spondylitis

作　　者：马涛涛 许雅芳 李东海 王丽娟 侯峰岩 郭辉 MA Tao-tao;XU Ya-fang;LI Dong-hai;WANG Li-juan;HOU Feng-yan;GUO Hui(Department of Radiology,Handan Integrated Traditional Chinese and Western Medicine Hospital,Handan 056001,Hebei,China;Department of Imaging,Hebei Petro China Central Hospital,Langfang 065000,Hebei,China;Department of Radiology,Zhangjiakou Second Hospital,Zhangjiakou 075000,Hebei,China;Department of Oncology,Affiliated Hospital of Hebei University of Engineering,Handan 056002,Hebei,China)

机构地区：[1]邯郸市中西医结合医院放射科,河北邯郸056001 [2]河北中石油中心医院影像科,河北廊坊065000 [3]张家口市第二医院放射科,河北张家口075000 [4]河北工程大学附属医院肿瘤科,河北邯郸056002

出　　处：《生物医学工程与临床》2025年第1期41-47,共7页Biomedical Engineering and Clinical Medicine

基　　金：廊坊市科学技术研究与发展计划项目(2022013128)。

摘　　要：目的探讨扩散加权成像(DWI)、动态正态MRI(DCE-MRI)及三维多回波数据合并成像联合水激发序列(3DMEDIC-WE)定量分析在强直性脊柱炎骶髂关节炎活动性评价中的应用。方法选择2022年1月至2024年1月在邯郸市中西医结合医院治疗的骶髂关节炎患者100例,其中男性61例,女性39例;年龄20~42岁,平均年龄31.50岁;身体质量指数19.20~24.50 kg/m^(2),平均身体质量指数22.09 kg/m^(2);吸烟39例,饮酒32例。所有患者接受DWI、DCE-MRI及3D-MEDIC-WE检查,比较活动期和稳定期患者影像参数差异。结果活动期患者52例,稳定期患者48例。活动期患者年龄为(28.83±8.21)岁,明显低于稳定期患者[(34.45±9.17)岁](P<0.05);活动期患者强直性脊柱炎疾病活动性指数(BASDAI)评分为(7.50±0.36)分,明显高于稳定期患者[(3.20±0.28)分](P<0.05);活动期患者表观扩散系数(ADC)为(1.10±0.25)×10^(-3)mm^(2)/s,明显高于稳定期患者[(0.26±0.08)×10^(-3)mm^(2)/s](P<0.05);活动期患者DCE-MRI定量参数容积转移常数(Ktrans)、反向速率常数(Kep)和细胞外容积分数(Ve)分别为(0.81±0.22)min^(-1)、(1.22±0.21)min^(-1)和0.67±0.19,明显高于稳定期患者[(0.40±0.18)min^(-1)、(0.88±0.24)min^(-1)和0.26±0.08](P<0.05);活动期与稳定期3DMEDIC-WE参数骶侧软骨厚度、髂侧软骨厚度和骶髂软骨厚度比较,差异无统计学意义(P>0.05);ADC、Ktrans、Kep和Ve诊断活动期的受试者工作特性曲线下面积分别为0.890、0.895、0.787和0.863(P<0.05)。结论DWI、DCE-MRI在评估强直性脊柱炎骶髂关节炎活动性方面有一定应用价值,而3D-MEDIC-WE无法判断强直性脊柱炎骶髂关节炎活动期。Objective To explore the application of diffusion weighted imaging(DWI),dynamic normal MRI(DCE-MRI)and three-dimensional multi echo data fusion imaging combined with water stimulation sequence(3D-MEDIC-WE)quantitative analysis in evaluating the sacroiliac arthritis activity of ankylosing spondylitis.Methods From January 2022 to January 2024,a total of 100 patients with sacroiliac arthritis were enrolled,which included 61 males and 39 females,aged 20-42 years old with mean age of 31.50 years old;body mass index(BMI)was 19.20-24.50 kg/m^(2) with mean BMI of 22.09 kg/m^(2);39 cases of smoking and 32 of drinking.All of them were performed with DWI,DCE-MRI and 3D-MEDIC-WE examination,and the differences of imaging parameters between active stage patients and stable stage patients were compared.Results There were 52 active stage patients and 48 stable stage patients,the age of active stage patients[(28.83±8.21)years old]was significantly lower than that of stable stage patients[(34.45±9.17)years old](P<0.05).The Bath ankylosing spondylitis disease activity index(BASDAI)score of active stage patients[(7.50±0.36)scores]was significantly higher than that of stable stage patients[(3.20±0.28)scores,P<0.05].The apparent diffusion coefficient(ADC)of active stage patients[(1.10±0.25)×10^(-3) mm^(2)/s]was significantly higher than that of stable stage patients[(0.26±0.08)×10^(-3) mm^(2)/s](P<0.05).The volume transfer constant(Ktrans),reverse rate constant(Kep)and extracellular volume fraction(Ve)of DCE-MRI quantitative parameters of active stage patients[(0.81±0.22)min^(-1),(1.22±0.21)min^(-1) and 0.67±0.19]were significantly higher than those of stable stage patients[(0.40±0.18)min^(-1),(0.88±0.24)min^(-1) and 0.26±0.08](P<0.05).There were no significant differences in sacral cartilage thickness,iliac cartilage thickness and sacroiliac cartilage thickness between active stage and stable stage 3D-MEDIC-WE parameters(P>0.05).The area under receiver operating characteristic curve for ADC value,Ktrans,Kep,and Ve in t

关 键 词：扩散加权成像 动态正态MRI 三维多回波数据合并成像联合水激发序列 强直性脊柱炎 骶髂关节炎 活动性 

分 类 号：R593.23[医药卫生—内科学] R445.2[医药卫生—临床医学]