脊柱MRI在强直性脊柱炎疗效评估中的应用

发布时间：2018-05-11 16:13

本文选题：脊柱炎 + 强直性　；参考：《山西医科大学》2014年硕士论文

【摘要】：目的：通过比较治疗前后强直性脊柱炎（AS）脊柱MRI的影像表现，探讨脊柱MRI在强直性脊柱炎（AS）疗效评估中的作用。方法：选取30例临床确诊的活动期AS患者，进行全脊柱MRI扫描，经过一个疗程治疗后复查全脊柱MRI。通过T1WI、STIR序列和DWI选取炎症椎体的感兴趣区域（ROI），在治疗前后对炎症椎体同一ROI测量表观弥散系数（ADC值），并对治疗前后炎症椎体ROI的ADC值进行配对t检验。选取患者正常椎体，在治疗前后对正常椎体同一ROI测量ADC值，对治疗前后正常椎体ROI的ADC值进行配对t检验。同时在治疗前后对AS患者作Bath强直性脊柱炎活动指数(BASDAI)评分，将治疗前后炎症椎体ADC值的变化与BASDAI评分的变化进行相关性分析。研究内容：（1）治疗前炎症椎体的DWI ADC值与正常椎体的DWI ADC值比较；（2）治疗前、后正常椎体的DWI ADC值比较；（3）治疗前、后炎症椎体的DWI ADC值比较；（4）治疗前后炎症椎体DWI ADC值的变化与BASDAI评分变化的相关性分析。（1）、（2）、（3）采用配对样本t检验。（4）采用Spearman相关分析。结果：（1）治疗前炎症椎体、治疗前正常椎体DWI ADC值分别为(1.20±0.07)、(0.50±0.10)×10-3mm2/s，二者间DWI ADC值有显著性差异（t=33.244,P0.001）。（2）治疗前、后正常椎体DWI ADC值分别为(0.50±0.10)、(0.50±0.10)×10-3mm2/s，二者间DWI ADC值差异无统计学意义（t=-1.528,P0.05）。（3）治疗前、后炎症椎体DWI ADC值分别为(1.20±0.07)、(0.70±0.10)×10-3mm2/s，，二者间DWI ADC值有显著性差异（t=23.610,P 0.001）。（4）治疗前、后炎症椎体DWI ADC值的变化与BASDAI评分变化呈正相关（r=0.704,P 0.05）。结论：（1）脊柱MRI能发现脊柱的活动期病灶；（2）脊柱DWI图像质量能满足诊断、测量要求；（3）DWI能定量评估AS患者的治疗效果,对临床上AS的疗效判定有一定的参考价值。
[Abstract]:Objective: To investigate the role of spinal MRI in evaluating the efficacy of ankylosing spondylitis (ASA) by comparing the imaging manifestations of spinal MRI before and after treatment. Methods: Thirty patients with active as were examined by MRI scan after a course of treatment. The area of interest of inflammatory vertebral body was selected by T1WISTIR sequence and DWI. The diffusion coefficient of the same ROI scale was measured before and after treatment, and the ADC value of ROI in inflammatory vertebral body was matched t test before and after treatment. The ADC value of the normal vertebral body was measured with the same ROI before and after treatment, and the ADC value of the ROI of the normal vertebral body before and after treatment was matched t test. At the same time, the Bath activity index of ankylosing spondylitis (Bath) was evaluated before and after treatment, and the correlation between the changes of ADC and BASDAI score was analyzed. Study content: (1) DWI ADC value of inflammatory vertebral body before treatment was compared with DWI ADC value of normal vertebral body. (2) DWI ADC value of normal vertebral body before treatment and DWI ADC value of normal vertebral body after treatment were compared before and after treatment. Comparison of DWI ADC value of postinflammatory vertebral body before and after treatment Spearman correlation analysis between the changes of DWI ADC value and BASDAI score was used. Results: 1) before treatment, the DWI ADC values of normal vertebrae and inflammatory vertebrae were 1.20 卤0.07 卤0.10) 脳 10 ~ (-3) mm ~ (2 / s), respectively. There was significant difference in DWI ADC between the two groups. The DWI ADC value of normal vertebral body before treatment was 0.50 卤0.10 ~ (0.10) 脳 10 ~ (-3) mm ~ (-2 / s). There was no significant difference in DWI ADC between the two groups before treatment. The DWI ADC values of postinflammatory vertebrae were 0.70 卤0.10) 脳 10 ~ (-3) mm ~ (2 / s) respectively. There was a significant difference in DWI ADC between the two groups before and after treatment. Before treatment, there was a positive correlation between the changes of DWI ADC and BASDAI scores (r _ (0.704) P _ (0.05). Conclusion: 1) Spinal MRI can find the active spinal lesions. The quality of spinal DWI images can meet the diagnostic requirements. The measurement of DWI images can quantitatively evaluate the therapeutic effect of as patients, and has a certain reference value for the clinical evaluation of the curative effect of as.
【学位授予单位】：山西医科大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R445.2;R593.23

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