分段读出EPI-DWI序列ADC值和SPARCC评分与中轴型脊柱关节炎活动性的相关性研究

Correlation between ADC Value Based on Readout-Segmented EPI-DWI Sequence and SPARCC Score and Activity of Axial Spondyloarthritis

目的探讨分段读出平面回波成像(RS-EPI)扩散加权成像(DWI)序列表观扩散系数(ADC)值和加拿大脊柱关节炎研究协会(SPARCC)评分与中轴型脊柱关节炎(axSpA)临床疾病活动指标(DAS)的相关性。方法回顾性分析50例临床确诊axSpA患者,临床DAS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-C-反应蛋白(CRP)和ASDAS-血沉(ESR)],两名观察者独立测量骶髂关节ADC值和SPARCC评分。应用受试者工作特征(ROC)曲线评价ADC值和SPARCC评分鉴别不同临床DAS的效能,并用Spearman相关系数评价两者相关性,应用组内相关系数(ICC)评价观察者间一致性。结果高活动度组患者ADC值和SPARCC评分显著高于低活动度组(P<0.01),两者诊断效能无明显差异;ADC值和SPARCC评分与BASDAI(r=0.50、0.49)、ASDAS-ESR(r=0.52、0.36)及ASDAS-CRP评分(r=0.54、0.44)均呈显著正相关;两名观察者测量ADC值和SPARCC的ICC值分别为0.98、0.88。结论RS-EPI DWI有望作为axSpA活动性的一种定量评价指标。

Objective To evaluate the correlation of ADC values derived from readout-segmented single-shot echo-planar imaging(RS-EPI)and Spondyloarthritis Research Consortium of Canada(SPARCC)MRI index with clinical disease activity index(DAS)in axial spondyloarthritis(axSpA).Methods This retrospective study included 50 patients.The clinical DAS included the Bath Ankylosing Spondylitis Disease Activity Index(BASDAI),Ankylosing Spondylitis Disease Activity Score(ASDAS)-C-reactive protein(CRP)and ASDAS-erythrocyte sedimentation rate(ESR).Two radiologists independently assessed ADC values and SPARCC scores.Receiver operating characteristic(ROC)analysis and Spearman rank correlation were used to test diagnostic performance of ADC values and SPARCC scores in distinguishing different clinical DAS and determining the correlations between them.Intraclass correlation coefficients(ICCs)were used to evaluate the interobserver agreements of ADC values and SPARCC scores.Results The ADC values and SPARCC scores of the high DAS group were significantly higher than the low DAS group(P<0.01).There was no significant difference on the diagnostic performance between ADC values and SPARCC scores.The ADC values and SPARCC scores showed significantly positive correlation with BASDAI(r=0.50,0.49),ASDAS-ESR(r=0.52,0.36)and ASDAS-CRP(r=0.54,0.44).The interobserver ICC values were 0.98 for ADC values,and 0.88 for SPARCC scores.Conclusion RS-EPI DWI may be a promising tool for the quantitative evaluation the clinical DAS in axSpA.