DWI在强直性脊柱炎所致骶髂关节炎活动性评价中的应用价值

Application value of DWI in sacroiliac arthritis activity caused by ankylosing spondylitis

目的:探讨DWI在强直性脊柱炎所致骶髂关节炎活动性评价中的应用价值。方法:收集81例骶髂关节炎患者,根据Bath强直性脊柱炎疾病活动指数(BASDAI)调查表、实验室检查结果分为活动组42例和稳定组39例,均行双侧骶髂关节常规MRI及DWI检查,测量并比较2组骶髂关节面下病变区的ADC值。结果:常规MRI及DWI可显示骶髂关节面软骨破坏、中断,关节面毛糙模糊,软骨下骨破坏、缺损,关节面下骨髓水肿、囊变、骨质增生硬化、脂肪沉积,关节间隙变窄、部分融合,累及周围肌肉,以及出现关节囊炎。活动组骶髂关节骶侧、髂侧的ADC值显著均高于稳定组,差异均有统计学意义(均P<0.01)。结论:DWI对强直性脊柱炎骶髂关节病变的诊断有重要意义,ADC值可为临床判断骶髂关节炎是否处于活动期提供依据。

Objective:To investigate the value of DWI in evaluating the activity of sacroiliac arthritis caused by ankylosing spondylitis.Methods:Totally 81 sacroiliitis patients were prospectively enrolled and divided into active group(42 cases)and stable group(39 cases)according to Bath ankylosing spondylitis disease activity index(BASDAI)scores and laboratory findings.Conventional MRI and DWI examination of bilateral sacroiliac joints were performed in all subjects.ADC values of the lesion area under the surface of sacroiliac joints were measured and compared between two groups.Results:Conventional MRI and DWI showed the disruption and interruption of sacroiliac articular cartilage,the articular surface was rough and fuzzy,the subchondral bone was destroyed and defective,joint bone edema and cystic changes,bone hyperplasia and sclerosis,fat deposition,joint fusion,lacuna narrowing,involvement of surrounding muscles,articular capsulitis.The ADC values of the sacral and iliac sides of sacroliac joint in the active group were significantly higher than those in the stable group(P<0.01).Conclusions:DWI is of great significance in the diagnosis of sacroiliac joint lesions in ankylosing spondylitis.ADC value can provide a basis for clinical judgment of whether sacroiliac arthritis is in active stage.