强直性脊柱炎骶髂关节ADC值、T1强化率与炎性活动指标的相关性

The relevance of ADC value , T1 intensive rate and the clinical activities in ankylosing spondylitis sacroiliitis

目的 评估扩散加权序列及对比增强MRI观察强直性脊柱炎活动组、稳定组及对照组的意义,探讨强直性脊柱炎骶髂关节ADC值、T1强化率与临床活性指标的相关性.方法 前瞻性的筛选2010年5月至2013年4月南方医科大学第三附属医院风湿免疫科56例强直性脊柱炎患者,活动组32例、稳定期24例,健康对照组20例.MR检查测量骶髂关节的表观扩散系数（ADC）值及T1强化率（△SI）,炎性活动指标：Bath强直性脊柱炎病情活动指数（BASDAI评分）、血沉及C-反应蛋白,统计学分析强直性脊柱炎活动组、稳定组及对照组的各参数差异是否有统计学意义,评估ADC值、T1强化率与BASDAI评分、血沉及C-反应蛋白的相关性.结果 ADC值活动组、稳定组及健康对照组分别为（1.45±0.25）× 10-3、（0.67±0.10）×10-3及（0.32±0.11）×10-3 mm2/s,与活动组比较差异均有统计学意义（均P＜0.01）.T1强化率3组差异均有统计学意义（均P＜0.01）,ADC值、△SI与BASDAI评分显著相关（r=0.824,0.794;均P＜0.01）.结论 扩散加权序列及对比增强序列对判断AS活动性优于临床活动性指标,结合临床活性指标可明显提高评价AS是否活动的准确性.

Objective To evaluate the value of judging for the activity in AS by diffusion-weighted sequences （DWI） and enhance sequences MRI（DCE-MRI）,to explore the correlation of Apparent diffusion coefficient（ADC） values,intensive rate and the clinical activity index in sacroiliitis （SIJ） of ankylosing spondylitis （AS）.Methods 56 patients prospectively choiced and diagnosed were divided into two groupsas,active group （n =32） and chronic group （n =24） by rheumatologist according to BASDAI and laboratory parameters.Twenty healthy adults were as control group.The values of ADC and intensive rate of all sacroiliac joints （SIJs） were measured on MRI.BASDAI score were got by Bath ankylosing spondylitis disease activity index.ESR,CPR and were got by laboratory.Statisticaly to analysis whether the parameters were significantly different amang AS active,chronic,and the control group.To assess the correlation of the values of ADC,intensive rate and BASDAI score,ESR,CPR and in SIJ.Results the values of ADC and intensive rate were significantly different among AS active,chronic and the control group.There were the significant correlation between the values of ADC,intensive rate and BASDAI score.Conclusion Diffusion-weighted sequences and Contrast-enhanced sequences is superior to other methods in judging the activity in AS.combined with clinical activity index,the accuracy can significantly be improved to explore whether the activities of AS are.