IVIM-DWI-MRI对强直性脊柱炎骶髂关节病变活动性的评估价值

The value of IVIM-DWI-MRI in the evaluation of sacroiliac joint activity in ankylosing spondylitis

目的探讨体素内不相干运动扩散加权成像(IVIM-DWI)-磁共振成像(MRI)对强直性脊柱炎(AS)骶髂关节病变活动性的评估价值。方法选取2018年3月至2021年3月本院AS患者128例作为AS组,男68例、女60例,平均年龄(31±9)岁,依据巴氏AS疾病活动指数(BASDAI)分为活动组(n=42)和稳定组(n=86),同期选取体检健康人员50例作为健康组,采用IVIM-DWI-MRI检测纯水分子扩散系数(D)、灌注相关伪扩散系数(D^(*))、灌注分数(f),比较各组D、D^(*)、f,分析IVIM-DWI-MRI对AS骶髂关节病变活动性的评估价值。结果AS组D、D^(*)、f高于健康组,差异有统计学意义(P<0.05);活动组D、D^(*)、f高于稳定组,差异有统计学意义(P<0.05);ROC曲线显示,在评估AS骶髂关节病变活动性的敏感度、特异度、曲线下面积中,D为76.19%、79.07%、0.817,D^(*)为66.67%、72.09%、0.765,f为71.43%、74.42%、0.803,D、D^(*)、f联合时为95.24%、93.02%、0.905,D、D^(*)、f联合高于单独D、D^(*)、f,差异有统计学意义(P<0.05)。结论IVIM-DWI-MRI中D、D^(*)、f等指标与AS骶髂关节病变活动性变化有关,可作为评估指标,且D、D^(*)、f联合时的评估价值更高。

Objective To discuss the value of incoherent motion diffusion-weighted imaging(IVIM DWI)-magnetic resonance imaging(MRI)in the evaluation of sacroiliac joint activity in ankylosing spondyli-tis(AS).Methods The 128 patients with AS in our hospital from March 2018 to March 2021 were selected as the AS group,which were divided into active group(n=42)and stable group(n=86)according to the Bas-dai disease activity index(BASDAI),and the 50 healthy persons were selected as the healthy group during the same period.The pure water molecular diffusion coefficient(D),perfusion-related pseudo diffusion coef-ficient(D^(*))and perfusion-related fraction(F)were detected by IVIM-DWI-MRI,and the D,D^(*)and F of the each groups were compared,the evaluation value of IVIM-DWI-MRI on the sacroiliac joint disease activity of AS were analyzed.Results The D,D^(*)and F in AS group were higher than those in healthy group,the difference was statistically significant(P<0.05).The D,D^(*)and F in the activity group were higher than those in the stable group,the difference was statistically significant(P<0.05).The ROC curve shows that,in the sensitivity,specificity,and area under the curve for assessing the sacroiliac joint activity of AS,the D were 76.19%,79.07%and 0.817;the D^(*)were 66.67%,72.09%,0.765;the F were 71.43%,74.42%and 0.803;The combined values of D,D^(*)and F were 95.24%,93.02%and 0.905,the combined values of D,D^(*)and F were higher than those of D,D^(*)and F alone,the difference was statistically significant(P<0.05).Conclusions The D,D^(*),F and other indexes in IVIM-DWI-MRI are related to the changes of the sacroiliac joint lesion ac-tivity,which can be used AS evaluation indexes,and the combined evaluation value of D,D^(*),F is higher.