IVIM-DWI对强直性脊柱炎活动性骶髂关节炎的诊断价值
发布时间：2018-04-27 11:40
本文选题：强直性脊柱炎 + 骶髂关节炎 ； 参考：《川北医学院》2017年硕士论文
【摘要】：目的:探讨体素内不相干运动扩散加权成像(intravoxel incoherent motion diffusion-weighted imaging,IVIM-DWI)诊断强直性脊柱炎(Ankylosing Spondylitis,AS)活动性骶髂关节炎的可行性及价值。材料与方法:随机收集川北医学院附属医院2016年5月至2017年2月风湿免疫科门诊及住院符合诊断标准的AS病人,共49例。实验组根据ESR,CPR,Bath强直性脊柱炎病情活动指数(BASDAI)分为活动期组和稳定期组。其中活动组21例,稳定组28例。对照组为28名健康志愿者。参照FS-T2WI及高b值(b=800s/mm~2)时的DWI图像来观察病灶,在图像后处理工作站DWI图像上放置ROI进行数据测量。记录纯水分子扩散系数(D),灌注相关的伪扩散系数(D*)以及灌注分数(f),采用单因素方差分析三组D、D*、f。采用Mann-Whitney U检验分析稳定组及活动组间的年龄、BASDAI评分、ESR及CRP。绘制ROC,比较各参数值的AUC以评定其诊断效能。结果:1、稳定组与活动组间的年龄差异无统计学差异(p0.05),活动组BASDAI评分、ESR及CRP高于稳定组,有统计学差异意义(p0.05)。2、IVIM参数:活动组D、D*、f值分别为(0.72±0.29)×10~(-3)mm~2/s、(5.79±3.58)×10~(-3)mm~2/s、(13.56±5.46)%;稳定组D、D*、f值分别为(0.35±0.16)×10~(-3)mm~2/s、(4.38±2.48)×10~(-3)mm~2/s、(9.68±3.18)%;对照组D、D*、f值分别为(0.29±0.08)×10~(-3)mm~2/s、(3.94±2.88)×10~(-3)mm~2/s、(10.38±4.23)%。结果显示三组间D值差异有统计学意义(p0.05)。活动组D*值高于稳定组、对照组,且差异有统计学意义(p0.05);稳定组与对照组间D*值差异无统计学意义(p0.05)。活动组f值高于稳定组、对照组,且差异有统计学意义(p0.05);稳定组与对照组间f值差异无统计学意义(p0.05)。3、ROC曲线:比较D、D*、f值在三组间的AUC,D值的AUC最大,其敏感性及特异性最高。活动组与稳定组间临界值(AUC、敏感性、特异性)为D=0.42×10~(-3)mm~2/s(0.870、83.80%、74.80%);活动组与对照组间临界值(AUC、敏感性、特异性)分别为D=0.38×10~(-3)mm~2/s(0.923、89.20%、85.30%)。结论:IVIM-DWI能有效、无创地反映AS活动期骶髂关节炎水分子扩散及微循环灌注状态,D值、D*值及f值有助于对AS活动性的诊断,其中D值的诊断效能最高。
[Abstract]:Objective: to investigate the feasibility and value of intravoxel incoherent motion diffusion-weighted imaging IVIM-DWI in the diagnosis of active sacroiliac arthritis in ankylosing spondylitis (ASA). Materials and methods: 49 patients with as who met the diagnostic criteria in the Department of Rheumatological Immunology from May 2016 to February 2017 in affiliated Hospital of North Sichuan Medical College were randomly collected. The experimental group was divided into active group and stable group according to the disease activity index of Bath ankylosing spondylitis. There were 21 cases in active group and 28 cases in stable group. The control group consisted of 28 healthy volunteers. The lesions were observed by referring to the DWI images of FS-T2WI and high b value of 800 s / mm ~ 2. ROI was placed on the DWI images of the image post-processing workstation to measure the data. The pure water molecular diffusion coefficient (DX), the perfusion related pseudo-diffusion coefficient (DX) and the perfusion fraction (FG) were recorded. The single factor analysis of variance (ANOVA) was used in three groups. Mann-Whitney U test was used to analyze the age and age of stable group and active group. Draw ROCand compare the AUC of each parameter value to evaluate its diagnostic efficiency. 缁撴灉:1,绋冲畾缁勪笌娲诲姩缁勯棿鐨勫勾榫勫樊寮傛棤缁熻瀛﹀樊寮，
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