MR类似CT限制回波间隔的快速场回波成像技术在强直性脊柱炎骶髂关节骨质结构改变中的诊断价值  

The Diagnostic Value of MR FRACTURE Imaging in Ankylosing Spondylitis with Bony Structural Anomalies of the Sacroiliac Joint

作　　者：谭晓倩 宋玲玲 李语 梁晨 程勇军 吴鹏 眭贺 宋德情 沈露 TAN Xiaoqian;SONG Lingling;LI Yu(Department of Imaging,Affiliated Hospital of Guizhou Medical University,Guiyang,Guizhou Province 550004,P.R.China)

机构地区：[1]贵州医科大学附属医院影像科,贵阳550004 [2]飞利浦医疗临床和技术支持部,上海200072

出　　处：《临床放射学杂志》2025年第3期536-540,共5页Journal of Clinical Radiology

基　　金：贵州省科学技术厅基金支持项目(编号:黔科合基础-ZK[2024]一般219)。

摘　　要：目的探讨类似CT限制回波间隔的快速场回波(FRACTURE)技术对强直性脊柱炎(AS)骶髂关节骨质结构改变的诊断价值。方法纳入2023年6月至2024年7月于贵州医科大学附属医院就诊且在检查前4周内已行骶髂关节CT平扫的AS患者41例,男35例,女6例,年龄21~44岁,平均(29.68±2.22)岁。AS患者行骶髂关节MRI常规扫描及FRACTURE扫描,对骶髂关节骨质结构改变进行诊断,以CT检查为对照,比较T 1WI和FRACTURE对骶髂关节结构性病变的诊断效能。结果两位观察者对三种成像技术诊断骶髂关节炎骨质结构性病变的诊断一致性较好(Kappa=0.716~0.963);FRACTURE在评估骨质结构改变方面,与CT的相关系数大于T 1WI;FRACTURE评估骶髂关节骨质侵蚀、硬化、关节间隙变化的敏感度及准确率均明显高于T 1WI,评估骨质侵蚀、硬化的特异度低于T 1WI;FRACTURE评估骨质结构改变置信度明显优于T 1WI(P<0.05);FRACTURE评估骨质侵蚀、关节间隙变化与CT相比,置信度差异无统计学意义(P>0.05)。结论FRACTURE技术可评估AS患者骶髂关节炎的骨质结构改变,诊断效能优于T 1WI,可达到与CT类似的诊断效果,具有替代骶髂关节CT检查的价值,从而减少辐射。Objective To investigate the diagnostic value of fast field echo resembling a CT using restricted echo-spacing(FRACTURE)for structural bone lesions of the sacroiliac joint in ankylosing spondylitis.Methods The study included 41 patients with ankylosing spondylitis(35 males and 6 females)aged 21-44 years,with a mean age of(29.68±2.22)years,who underwent CT scanning of the sacroiliac joints within 4 weeks prior to enrollment at the Affiliated Hospital of Guizhou Medical University between June 2023 and July 2024.Sacroiliac joint bone structural changes were diagnosed using MRI,including both conventional T 1-weighted imaging(T 1WI)and FRACTURE sequences,with CT findings serving as the reference standard.The diagnostic efficacy of T 1WI and FRACTURE for structural lesions of the sacroiliac joint was compared.Results The diagnostic agreement between the three imaging techniques for sacroiliac arthritis bone structural lesions was good between the two observers(Kappa=0.716-0.963).The correlation coefficients of FRACTURE with CT were higher than those of T 1WI in assessing bone structural changes.The sensitivity and accuracy of FRACTURE in assessing bone erosion,sclerosis,and joint space changes in the sacroiliac joints were significantly higher than those of T 1WI.The specificity of FRACTURE in assessing bone erosion and sclerosis was lower than that of T 1WI.The confidence level of FRACTURE in assessing bone structural changes was significantly better than that of T 1WI(P<0.05).The differences in confidence levels of FRACTURE in assessing bone erosion and joint space changes compared with CT were not statistically significant(P>0.05).Conclusion FRACTURE provides better diagnostic efficacy than T 1WI for evaluating bone structural changes associated with sacroiliac arthritis in ankylosing spondylitis patients.It can achieve diagnostic results similar to CT while avoiding radiation exposure,thus potentially replacing CT scans of the sacroiliac joints.

关 键 词：磁共振成像 FRACTURE 强直性脊柱炎 骶髂关节 结构性病变 

分 类 号：R68[医药卫生—骨科学]