磁共振成像Dixon序列评价强直性脊柱炎患者骶髂关节骨髓水肿的价值

Value of Dixon magnetic resonance imaging sequence in diagnosis of marrow edema of the sacroiliac joint in patients with ankylosing spondylitis

目的 探讨磁共振Dixon序列在评价强直性脊柱炎（ankylosing spondylitis,AS）患者骶髂关节骨髓水肿中的应用价值。方法 收集本院2016年11月至2018年2月AS患者40例作为研究组,同期健康体检者20例作为对照组。AS患者入院后均行Bath强直性脊柱炎疾病活动度指数（Bath ankylosing spondylitis disease activity index,BASDAI）、Bath强直性脊柱炎功能指数（Bath ankylosing spondylitis functional index,BASFI）评分及C反应蛋白、血沉检查。研究组及对照组均行骶髂关节MRI常规序列及Dixon序列扫描,通过后处理工作站对各受检者Dixon序列图像进行分析,测量双侧骶髂关节面下Dixon序列水信号值。研究组双侧骶髂关节面下Dixon序列水信号值与BASDAI评分、BASFI评分、C反应蛋白、血沉及加拿大脊柱关节炎研究协会（spondyloarthritis research consortium Canada,SPARCC）骶髂关节评分进行相关性分析。结果 研究组双侧骶髂关节面下Dixon序列水信号值均显著高于对照组（P 〈0. 05）;研究组双侧骶髂关节面下Dixon序列水信号值与BASDAI评分、BASFI评分、C反应蛋白、血沉及骶髂关节SPARCC评分均呈正相关关系（P 〈0. 05）。结论 磁共振Dixon序列可以作为评价骶髂关节炎活动期的参考指标。

Objective To investigate the value of Dixon magnetic resonance imaging （MRI） sequence in the diagnosis of marrow edema of the sacroiliac joint in patients with ankylosing spondylitis （AS）. Methods Forty patients with AS admitted in our hospital between November, 2016 and February, 2018 were selected as the case group and 20 healthy subjects recruited during the same time served as the control group. All the patients were assessed with Bath ankylosing spondylitis disease activity index （BASDAI） and Bath ankylosing spondylitis functional index （BASFI） and examined for C-reactive protein and erythrocyte sedimentation rate （ESR） after admission. The routine MRI sequence and Dixon sequence scan of the sacroiliac joint were performed in both groups. The Dixon sequence images of the subjects were analyzed using post-processing workstation, and the water signal intensity under the surface of the bilateral sacroiliac joints were measured and compared between the 2 groups. In the case group, the correlations were analyzed of water signal intensity of Dixon sequence under the bilateral sacroiliac joint with BASDAI, BASFI, C-reactive protein, ESR and sacroiliac joint SPARCC score. Results The water signal intensity under the bilateral sacroiliac joints on Dixon sequence images was significantly higher in the case group than in the healthy control group （ P 〈 0.05 ）. In the case group, water signal intensity under the bilateral sacroiliac joints was positively correlated with BASDAI, BASFI, C-reactive protein, ESR and the sacroiliac joint SPARCC score of the patients （P 〈 0. 05）. Conclusion Dixon MRI sequence can be used as an indicator for evaluating the active stage of sacroiliac arthritis in patients with AS.