多普勒超声在早期活动性中轴型脊柱关节病中的应用

Application value of Doppler ultrasound in early active axial spondyloarthropathy

目的探讨多普勒超声诊断中轴型脊柱关节病(axSpA)患者活动性骶髂关节炎的价值。方法回顾性分析51例早期axSpA患者的多普勒超声及MRI资料。依据MRI结果将axSpA患者分为活动性骶髂关节炎(活动)组及非活动性骶髂关节炎(非活动)组,比较2组骶髂关节的血流显示情况及血流阻力指数(RI)。以MRI结果为金标准,绘制ROC曲线,评价RI对axSpA患者活动性骶髂关节炎的诊断效能。结果活动组32例共58个病变关节(6例为单发活动性骶髂关节炎),非活动组19例共38个病变关节。活动组骶髂关节血流显示率(51/58,87.93%)高于非活动组(26/38,68.42%;χ~2=5.505,P=0.019)。2组间血流分级差异无统计学意义(Z=-1.93,P=0.053)。活动组RI值(0.59±0.08)低于非活动组(0.71±0.09;t=-6.04,P<0.001)。以RI=0.64诊断axSpA患者活动性骶髂关节炎,敏感度为80.8%,特异度为74.5%,准确率为78.7%。结论利用多普勒超声可通过骶髂关节周围及内部的异常血流来反映axSpA患者活动性骶髂关节炎,且准确率较高。

Objective s To investigate the value of Doppler ultrasound in diagnosing active sacroiliitis of axial spondyloarthropathy（axSpA）patients.Methods The Doppler ultrasound and MRI data of 51 patients with early axSpA was retrospectively analyzed.According to MRI results,axSpA patients were divided into active sacroiliitis（active group）and inactive sacroiliitis（inactive group）.The color flow display and blood flow resistance index（RI）were compared.Considering MRI as the diagnostic standard,ROC curve was used to evaluate the diagnostic efficacy of RI in detecting active sacroiliitis.Results There were 32 cases wth 58 joints（6 cases were single active sacroiliitis）in activity group and 19 cases with 38 joints in inactivity group.The flow signals demonstration rate of sacroiliac joint in activity group（51/58,87.93%）was higher than that in inactive group（26/38,68.42%;χ2=5.505,P=0.019）.There was no statistical difference of the indegree of blood flow between the two groups（Z=-1.93,P=0.053）.RI in active group（0.59±0.08）was lower than that in inactive group（0.71±0.09;t=-6.04;P0.001）.Taking RI=0.64 for diagnosis of active sacoriliitis in axSpA patients,the sensitivity,specificity and accuracy rate were 80.8%,74.5% and 78.7%,respectively.Conclusion Through observing abnormal blood flow signals around and internal the sacroiliac joints,ultrasonography can response active sacroiliitis in axSpA patients with higher accuracy.