DWI、DCE-MRI诊断骶髂关节急性炎症的价值

发布时间：2018-04-11 15:58

本文选题：骶髂关节炎 + 磁共振成像　；参考：《放射学实践》2017年09期

【摘要】：目的:探讨DWI、DCE-MRI诊断骶髂关节(SIJ)急性炎症的价值。方法:选取42例骶髂关节炎患者及18例志愿者(对照组),对所有60例受检者行双侧骶髂关节MR平扫、动态增强MRI(DCE-MRI)及扩散加权成像(DWI)检查。根据TIRM-T2WI序列上骨髓信号是否增高将42例患者分为急性炎症组(18例)和非急性炎症组(24例)。对急性炎症组患者进行SPARCC评分。描绘时间-信号曲线(TIC)并对其进行分型;计算、测量各组骨髓区的增强因子(Fenh)、增强斜率(Senh)及表观扩散系数(ADC)值。并对急性炎症组患者的SPARCC评分、ADC值及Fenh三者间进行相关性分析。结果:急性炎症组SPARCC评分为(21.06±7.20)分。TIRM-T2WI、DWI及DCE-MRI分别检出35、34、36侧关节面下急性炎症,三者间检测能力差异无统计学意义(χ2=2.06,P0.05)。急性炎症组病变区ADC值、Fenh及Senh均高于非急性炎症组、对照组,差异均有统计学意义(F值分别为381.591、62.080、11.097,P值均0.01);非急性炎症组与对照组上述三个参数间差异无统计学意义(P值均0.05)。急性炎症组TIC表现为快速上升平台型(72.22%)和持续快速上升型(27.78%);非急性炎症组和对照组TIC均表现为速升缓降型。急性炎症组的SPARCC评分与ADC值、SPARCC评分与Fenh、ADC值与Fenh均呈正相关(r值分别为0.874、0.673、0.723,P值均0.05)。结论:DWI、DCE-MRI检出SIJ急性炎症的能力相当;通过计算ADC值、Fenh及Senh可对炎性病变程度进行量化评价,DWI、DCE-MRI对SIJ急性炎症的诊断具有重要价值。
[Abstract]:Objective: to evaluate the value of DWI DCE-MRI in the diagnosis of acute inflammation of sacroiliac joint (SIJ).Methods: a total of 42 patients with sacroiliac arthritis and 18 volunteers (control group) were examined with Mr plain scan, dynamic contrast enhanced Mr imaging (DCE-MRI) and diffusion weighted imaging (DWI) of bilateral sacroiliac joint.According to TIRM-T2WI sequence, 42 patients were divided into acute inflammation group (n = 18) and non-acute inflammation group (n = 24).The patients in acute inflammation group were assessed with SPARCC.The time-signal curve (TIC) was described and classified, and the enhancement factor (Fenhan), enhanced slope (Senhan) and apparent diffusion coefficient (ADCC) of bone marrow area in each group were measured.The correlation between SPARCC score and Fenh in acute inflammation group was analyzed.Results: the SPARCC score of acute inflammation group was 21.06 卤7.20. The acute subarticular inflammation was detected by TIRM-T2WIWI and DCE-MRI, respectively. There was no significant difference among the three groups (蠂 2. 06, P 0. 05).The values of ADC and Senh in the acute inflammation group were higher than those in the non-acute inflammation group, and in the control group, the difference was statistically significant (P = 381.591U, 62.080 / 11.097, P = 0.01), but there was no significant difference between the non-acute inflammation group and the control group in the above three parameters (P = 0.05).The TIC of acute inflammation group was 72.22) and that of continuous rapid rising type was 27.78%, and that of non-acute inflammation group and control group was rapid ascending and slowly descending type.In acute inflammation group, the SPARCC score and ADC value, SPARCC score, Fenhan ADC value and Fenh were positively correlated with Fenh, the r values were 0.874 卤0.673 卤0.723 (P = 0.05), respectively.Conclusion the ability of DCE-MRI to detect acute inflammation of SIJ is equal to that of DCE-MRI, and it is important to evaluate the degree of acute inflammation of SIJ by calculating ADC value and Senh.
【作者单位】：青岛大学附属烟台毓璜顶医院影像科磁共振室;
【基金】：烟台市重点研发计划项目(2016ws026)
【分类号】：R445.2;R684.3

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