MRI脂肪抑制技术STIR序列应用于强直性脊柱炎骶髂关节检测的价值

Value of Application of MRI Fat Suppression Technique STIR Sequence in Detecting Sacroiliac Joint in Ankylosing Spondylitis

目的:探讨磁共振成像(MRI)脂肪抑制技术短时间反转恢复(STIR)序列应用于强直性脊柱炎(AS)骶髂关节检测的价值。方法:选取2022年1月—2023年7月郑州市中医院收治的60例AS患者作为研究对象。所有患者均进行磁共振成像扫描,扫描序列包括T1加权像(T1WI)、T2加权像(T2WI)、T2加权脂肪抑制(FS-T2WI)及短时间反转恢复序列(STIR)。记录各序列扫描的异常信号,并对比两种脂肪抑制序列骶髂关节左右两侧影像均匀性、两侧臀部肌肉的SNR及CNR、骨髓水肿患者的SNR与CNR、两种脂肪抑制序列图像质量相关评分。结果:经MRI检测,60例AS患者中发现信号异常患者:T1WI 51例(85.00%),T2WI 48例(80.00%),脂肪抑制(FS-T2WI及STIR)59例(98.33%);60例患者中,FS序列右侧图像均匀性较左侧高,FS序列右侧SNR较左侧高,CNR较左侧低,差异有统计学意义(t=1359.047、19.022、21.410,P<0.05);32例骨髓水肿患者STIR序列SNR及CNR均较FS序列高,差异有统计学意义(t=6.457、6.330,P<0.05);STIR序列脂肪抑制均匀性、病变明显性、伪影、整体质量较FS序列高,解剖结构评分较FS序列低,差异有统计学意义(t=44.274、73.891、34.326、25.544、20.440,P<0.05)。结论:采用MRI脂肪抑制技术能够早发现强直性脊柱炎骶髂关节骨髓水肿,且脂肪抑制序列中的STIR序列图像质量更好,尤其对于骨髓水肿患者显示效果更好。

Objective:To investigate the value of MRI fat suppression technique in the detection of sacroiliac joint in ankylosing spondylitis(AS).Methods:60 patients with AS in the hospital from January 2022 to July 2023 were studied.All patients underwent magnetic resonance imaging(MRI).The scan sequences included T1-weighted images(T1WI),T2-weighted images(T2WI),T2-weighted fat suppression(FS-T2WI)and short time reversal recovery sequences(STIR).The abnormal signals of each scan sequence were recorded,and the image uniformity of the left and right sides of the sacroiliac joint,SNR and CNR of the buttock muscle on both sides,and the image quality scores of the SNR and CNR of the patients with bone marrow edema were compared.Results:In 60 patients with AS,signal abnormalities were detected by MRI:51 patients with T1WI(85.00%),48 patients with T2WI(80.00%),59 patients with fat inhibition(FS-T2WI and STIR)(98.33%).Among the 60 patients,the image uniformity of the right side of FS sequence was higher than that of the left side,the SNR of the right side of FS sequence was higher than that of the left side,and the CNR was lower than that of the left side,with statistically significant difference(t=1359.047,19.022,21.410;P<0.05).STIR sequence SNR and CNR of 32 patients with bone marrow edema were higher than FS sequence,and the difference was statistically significant(t=6.457,6.330;P<0.05).The fat inhibition uniformity,lesion significance,artifact,and overall quality of STIR sequence were higher than those of FS sequence,and the anatomical structure score was lower than FS sequence,with statistically significant difference(t=44.274,73.891,34.326,25.544,20.440;P<0.05).Conclusion:MRI fat suppression technique can detect bone marrow edema of sacroiliac joint in ankylosing spondylitis early,and STIR sequences of fat suppression sequence have better image quality,especially for patients with bone marrow edema.So it is worthy of clinical promotion.