Ankylosing spondylitis(AS) is a chronic inflammatory disease that affects 1% of the general population. As one of the most severe types of spondyloarthropathy, AS affects the spinal vertebrae and sacroiliac joints, ca...Ankylosing spondylitis(AS) is a chronic inflammatory disease that affects 1% of the general population. As one of the most severe types of spondyloarthropathy, AS affects the spinal vertebrae and sacroiliac joints, causing debilitating pain and loss of mobility. The goal of this review is to provide an overview of AS, from the pathophysiological changes that occur as the disease progresses, to genetic factors that are involved with its onset. Considering the high prevalence in the population, and the debilitating life changes that occur as a result of the disease, a strong emphasis is placed on the diagnostic imaging methods that are used to detect this condition, as well as several treatment methods that could improve the health of individuals diagnosed with AS.展开更多
Background： Previous studies showed that combining apparent diffusion coefficient （ADC） value with the Spondyloarthritis Research Consortium of Canada （SPARCC） index value might provide a reliable evaluation of t...Background： Previous studies showed that combining apparent diffusion coefficient （ADC） value with the Spondyloarthritis Research Consortium of Canada （SPARCC） index value might provide a reliable evaluation of the activity of ankylosing spondylitis （AS）, and that contrast-enhanced （CE） magnetic resonance imaging （MRI） is unnecessary. However, the results were based on confirming only a small random sample. This study aimed to assess the role of CE-MRI in differentiating the disease activity of AS by comparingADC value with a large sample. Methods： A total of l 15 patients with AS were enrolled in accordance with Bath AS Disease Activity Index and laboratory indices, and 115 patients were divided into two groups, including active group （n = 69） and inactive group （n 46）. SPARCC, ASI, and ADC values were obtained from the short tau inversion recovery （STIR）, diffusion-weighted imaging （DWI）, and CE-MRI, respectively. One-way analysis of variance and receiver operating characteristic analysis were performed for all parameters. Results： The optimal cutoff values （with sensitivity, specificity, respective area under the curve, positive likelihood ratio, and negative likelihood ratio） for the differentiation between active and inactive groups are as follows： SPARCC = 6 （72.06%, 82.61%, 0.836, 4.14, 0.34）; ASI （%） 153 （80.6%, 84.78%, 0.819, 5.3, 0.23）; ADC value - 1.15 × 10 3 mm2/s （72.73% 81.82%, 0.786, 4, 0.33）. No statistical differences were found among the predictive values of SPARCC, △SI, and ADC. Multivariate analysis showed no significant difference between the combination of SPARCC and ADC values with and without ASI. Conclusions： Using large sample, we concluded that the combination of STIR and DWI would play significant roles in assessing the disease activity, and CE-MRI sequence is not routinely used in imaging of AS to avoid renal fibrosis and aggravation of kidney disease.展开更多
目的:探讨全身MRI在强直性脊柱炎(AS)活动性炎症中的评估价值。方法:对96例经临床确诊的AS患者进行全身MRI扫描,评估活动性炎症累及的部位(主要包括骶髂关节、脊柱及肩关节、髋关节等外周大关节,共计23个部位),并采用加拿大脊柱关节炎...目的:探讨全身MRI在强直性脊柱炎(AS)活动性炎症中的评估价值。方法:对96例经临床确诊的AS患者进行全身MRI扫描,评估活动性炎症累及的部位(主要包括骶髂关节、脊柱及肩关节、髋关节等外周大关节,共计23个部位),并采用加拿大脊柱关节炎研究协会(SPARCC)评分方法对脊柱和骶髂关节炎症进行评分。采用卡方检验或Fisher精确检验(频数小于5时)比较短病程(病程<5年)组(41例)和长病程(病程≥5年)组(55例)之间各部位活动性炎症的受累率,采用t检验比较两组患者SPARCC评分的差异。采用单因素分析确定两组之间活动性炎症发生率具有差异的部位后,采用二元logistic回归分析筛选出与长病程显著相关的受累部位。结果:短病程组中活动性骶髂关节炎的发生率明显高于长病程组(44/82 vs. 37/110,P<0.05);椎角炎、椎小关节炎、肋横突关节炎、股骨大转子附着点炎、棘突附着点炎、胸肋关节炎、耻骨联合炎、髂后上棘及耻骨下支附着点炎在长病程组中的发生率均高于短病程组(P<0.05)。短病程组的骶髂关节SPARCC评分明显高于长病程组(11.220±12.817 vs. 3.854±7.327,P<0.05),脊柱SPARCC评分明显低于长病程组(7.584±7.635 vs. 16.098±13.225,P<0.05)。二元logistic回归分析结果显示骶髂关节炎(OR=0.322,P=0.002)、耻骨联合炎(OR=5.045,P=0.025)和脊柱SPARCC评分(OR=1.102,P=0.002)与长病程具有显著相关性。结论:全身磁共振成像可以全面评估强直性脊柱炎患者活动性炎症的分布情况。病程早期骶髂关节活动性炎症较明显,而慢性期更易出现脊柱、其它周围关节及肌腱附着点的活动性炎症。展开更多
文摘Ankylosing spondylitis(AS) is a chronic inflammatory disease that affects 1% of the general population. As one of the most severe types of spondyloarthropathy, AS affects the spinal vertebrae and sacroiliac joints, causing debilitating pain and loss of mobility. The goal of this review is to provide an overview of AS, from the pathophysiological changes that occur as the disease progresses, to genetic factors that are involved with its onset. Considering the high prevalence in the population, and the debilitating life changes that occur as a result of the disease, a strong emphasis is placed on the diagnostic imaging methods that are used to detect this condition, as well as several treatment methods that could improve the health of individuals diagnosed with AS.
文摘Background： Previous studies showed that combining apparent diffusion coefficient （ADC） value with the Spondyloarthritis Research Consortium of Canada （SPARCC） index value might provide a reliable evaluation of the activity of ankylosing spondylitis （AS）, and that contrast-enhanced （CE） magnetic resonance imaging （MRI） is unnecessary. However, the results were based on confirming only a small random sample. This study aimed to assess the role of CE-MRI in differentiating the disease activity of AS by comparingADC value with a large sample. Methods： A total of l 15 patients with AS were enrolled in accordance with Bath AS Disease Activity Index and laboratory indices, and 115 patients were divided into two groups, including active group （n = 69） and inactive group （n 46）. SPARCC, ASI, and ADC values were obtained from the short tau inversion recovery （STIR）, diffusion-weighted imaging （DWI）, and CE-MRI, respectively. One-way analysis of variance and receiver operating characteristic analysis were performed for all parameters. Results： The optimal cutoff values （with sensitivity, specificity, respective area under the curve, positive likelihood ratio, and negative likelihood ratio） for the differentiation between active and inactive groups are as follows： SPARCC = 6 （72.06%, 82.61%, 0.836, 4.14, 0.34）; ASI （%） 153 （80.6%, 84.78%, 0.819, 5.3, 0.23）; ADC value - 1.15 × 10 3 mm2/s （72.73% 81.82%, 0.786, 4, 0.33）. No statistical differences were found among the predictive values of SPARCC, △SI, and ADC. Multivariate analysis showed no significant difference between the combination of SPARCC and ADC values with and without ASI. Conclusions： Using large sample, we concluded that the combination of STIR and DWI would play significant roles in assessing the disease activity, and CE-MRI sequence is not routinely used in imaging of AS to avoid renal fibrosis and aggravation of kidney disease.
文摘目的:探讨全身MRI在强直性脊柱炎(AS)活动性炎症中的评估价值。方法:对96例经临床确诊的AS患者进行全身MRI扫描,评估活动性炎症累及的部位(主要包括骶髂关节、脊柱及肩关节、髋关节等外周大关节,共计23个部位),并采用加拿大脊柱关节炎研究协会(SPARCC)评分方法对脊柱和骶髂关节炎症进行评分。采用卡方检验或Fisher精确检验(频数小于5时)比较短病程(病程<5年)组(41例)和长病程(病程≥5年)组(55例)之间各部位活动性炎症的受累率,采用t检验比较两组患者SPARCC评分的差异。采用单因素分析确定两组之间活动性炎症发生率具有差异的部位后,采用二元logistic回归分析筛选出与长病程显著相关的受累部位。结果:短病程组中活动性骶髂关节炎的发生率明显高于长病程组(44/82 vs. 37/110,P<0.05);椎角炎、椎小关节炎、肋横突关节炎、股骨大转子附着点炎、棘突附着点炎、胸肋关节炎、耻骨联合炎、髂后上棘及耻骨下支附着点炎在长病程组中的发生率均高于短病程组(P<0.05)。短病程组的骶髂关节SPARCC评分明显高于长病程组(11.220±12.817 vs. 3.854±7.327,P<0.05),脊柱SPARCC评分明显低于长病程组(7.584±7.635 vs. 16.098±13.225,P<0.05)。二元logistic回归分析结果显示骶髂关节炎(OR=0.322,P=0.002)、耻骨联合炎(OR=5.045,P=0.025)和脊柱SPARCC评分(OR=1.102,P=0.002)与长病程具有显著相关性。结论:全身磁共振成像可以全面评估强直性脊柱炎患者活动性炎症的分布情况。病程早期骶髂关节活动性炎症较明显,而慢性期更易出现脊柱、其它周围关节及肌腱附着点的活动性炎症。
