T_(2) mapping评估放射学阴性中轴型脊柱关节炎疾病活动性的应用价值

The Value of T_(2) mapping for Evaluating Disease Activity in non-Radiographic Axial Spondyloarthritis

目的探讨T_(2) mapping评估放射学阴性中轴型脊柱关节炎(nr-axSpA)活动性的价值。方法回顾性搜集43例nr-axSpA患者的临床活动度评分(CAS)包括Bath强直性脊柱炎活动指数(BASDAI)和强直性脊柱炎疾病活动评分(ASDAS-CRP和ASDAS-ESR),根据ASDAS-CRP评分分为高活动度组和低活动度组。由两名观察者独立测量加拿大脊柱关节炎研究协会(SPARCC)评分、T_(2)值和相对T_(2)(rT_(2))值。采用Spearman相关系数分析MRI指标与CAS的相关性,比较高低活动度组年龄、性别、CRP、ESR、SPARCC评分、T_(2)值和rT_(2)值的差异,将差异有统计学意义的危险因素进行二元Logistic回归分析,应用ROC评价SPARCC评分、T_(2)值、rT_(2)值和联合参数诊断高活动度的效能。结果SPARCC评分、T_(2)值和rT_(2)值与3种CAS均呈显著正相关。高活动度组患者26例,低活动度组患者17例,两组间性别、CRP、ESR、SPARCC评分、T_(2)值和rT_(2)值差异有统计学意义,二元Logistic回归分析结果表明rT_(2)值和CRP升高是高活动度的独立危险因素。SPARCC评分、T_(2)值、rT_(2)值和联合参数诊断高活动度的AUC值分别为0.684、0.778、0.855、0.932。结论T_(2) mapping定量参数有助于评估nr-axSpA活动性,rT_(2)值联合CRP是预测高活动度的最佳指标。

Objective To explore the value of T_(2) mapping for evaluating disease activity in non-radiographic axial Spondyloarthritis(nr-axSpA).Methods 43 nr-axSpA patients were included in this retrospective study.Clinical activity scores(CASs)including the Bath Ankylosing Spondylitis Disease Activity Index(BASDAI),Ankylosing Spondylitis Disease Activity Score(ASDAS)-C-reactive protein(CRP)and ASDAS-erythrocyte sedimentation rate(ESR)were recorded.According to the ASDAS-CRP,patients were divided into high activity group and low activity group.Two radiologists independently assessed Spondyloarthritis Research Consortium of Canada(SPARCC)scores,T_(2) values and relative T_(2)(rT_(2))values.Spearman’s rank correlation was used to assess the correlation between MRI-based indexes and CAS.Age,gender,CRP,ESR,SPARCC scores,T_(2) values and rT_(2) values were compared between two groups.Factors with significant statistical differences were further analyzed by binary logistic regression.The receiver operating curve(ROC)was used to evaluate the diagnostic efficiency of SPARCC scores,T_(2) values,rT_(2) values and combined parameters.Results SPARCC scores,T_(2) values and rT_(2) values exhibited significantly positive correlations with three CASs.26 patients were included in high activity group and 17 patients were included in low activity group.Binary logistic regression analysis showed that rT_(2) values and CRP were independent risk factors in high activity group.The ROC curve analysis showed that the area under curve of the SPARCC scores,T_(2) values,rT_(2) values and combined parameters were 0.684,0.778,0.855,0.932,respectively.Conclusion Quantitative T_(2) mapping parameters could evaluate disease activity of nr-axSpA,and rT_(2) values combined with CRP were the most valuable indexes in predicting high activity group.