RESOLVE弥散加权成像评估中轴型脊柱关节炎骶髂关节活动性病变

RESOLVE diffusion weighted imaging in evaluation on sacroiliacjoint active lesions caused by axial spondyloarthritis

目的观察不同b值RESOLVE弥散加权成像(DWI)评估中轴型脊柱关节炎(SpA)骶髂关节活动性病变的价值。方法纳入70例临床诊断SpA患者(SpA组)和17例骶髂关节正常者(对照组);SpA组再分为活动亚组和非活动亚组。行骶髂关节常规MRI及不同b值RESOLVE DWI,测量骶髂关节软骨下骨髓区域表观弥散系数(ADC),ADC1为b=50、500 s/mm^(2)拟合,ADC2为b=50、700 s/mm^(2)拟合,ADC3为b=50、500、700 s/mm^(2)拟合;比较不同b值RESOLVE DWI在2组的诊断效能。结果SpA组整体及其非活动亚组和活动亚组骶髂关节软骨下骨髓在不同b值RESOLVE DWI中的ADC值均高于对照组(P均<0.05);非活动亚组ADC2和ADC3均低于活动亚组(P均<0.05),而ADC1差异无统计学意义(P>0.05)。ADC3的曲线下面积大于ADC2及ADC1。结论多b值拟合(b=50、500、700 s/mm^(2))RESOLVE DWI可兼顾图像质量及显示病灶;ADC可作为定量指标评估SpA骶髂关节活动性病变,为临床诊断及治疗提供有效帮助。

Objective To observe the value of different b values of RESOLVE diffusion weighted imaging(DWI)in evaluating sacroiliac joints active lesions in patients with axial spondyloarthritis(SpA).Methods Totally 70 patients with clinically diagnosed SpA(SpA group)and 17 patients with normal sacroiliac joints(control group)were enrolled.Patients in SpA group were divided into active subgroup or inactive subgroup.Routine MRI of sacroiliac joint and RESOLVE DWI with different b-values were performed.The apparent diffusion coefficient(ADC)of subchondral bone marrow of sacroiliac joints were measured.ADC1 was b=50,500 s/mm^(2) fitting,ADC2 was b=50,700 s/mm^(2) fitting,and ADC3 was b=50,500,700 s/mm^(2) fitting.The diagnostic efficacy of RESOLVE DWI with different b values were compared between groups and subgroups.Results ADC of subchondral bone marrow of sacroiliac joints obtained with different b values in whole SpA group and 2 subgroups were all higher than that in control group(all P<0.05).ADC2 and ADC3 in inactive subgroup were all lower than that in active subgroup(both P<0.05),but there was no significant difference of ADC1 was found between subgroups(P>0.05).The area under the curve of ADC3 was larger than that of ADC1 and ADC2.Conclusion Multi-b-value fitting(b=50,500,700 s/mm^(2))RESOLVE DWI took focus detection and imaging quality into account,and ADC might be regarded as an effective quantitative index for clinical diagnosis and treatment of active lesions of sacroiliac joint caused by SpA.