摘要
目的探讨3.0 T磁共振动态增强技术在判断AS患者髋关节病变活动性中的应用价值。方法回顾性分析2013年1月至2016年12月经我院风湿科确诊的52例AS髋关节受累患者资料。对所有患者进行强直性脊柱关节炎病情活动度（ASDAS）-CRP评分、患者对髋关节活动度评价及医生对髋关节活动度评价，根据ASDAS-CRP评分将患者分为活动期组34例及缓解期组18例。所有患者经确诊分组后均行双髋关节MRI平扫加动态增强扫描及图像后处理分析，分别选取病变髋关节周围滑膜异常强化区域6个感兴趣区，自动生成时间-信号曲线（TIC），描述曲线形态并测量第3、4个时相的早期强化率，将活动期组及缓解期组早期强化率分别进行统计学分析，采用2个独立样本t检验，以P〈0.05为差异具有统计学意义。将第3、4个时相的早期强化率分别与ASDAS-CRP评分、患者对髋关节活动度评价及医生对髋关节活动度评价进行Pearson相关性分析。结果活动期组TIC曲线形态为快速上升平台型或快速持续上升型，缓解期组曲线为缓慢上升型。活动期组第3、4个时相的强化率[分别为（116±9）%、（146±12）%均高于缓解期组（23±5）%、（43±14）%]，差异具有统计学意义（t=2.447，3.054，P〈0.05）。第3、4个时相的滑膜强化率均与ASDAS-CRP评分呈正相关（r=0.802，0.836；P值均=0.01）；与患者对髋关节活动度评价相关性较差（r=0.352，0.458；P=0.02，0.01）；与医生对髋关节活动度评价有较好的相关性（r=0.652，0.717；P值均=0.01）。结论磁共振动态增强TIC曲线的形状、早期强化率对判断AS髋关节病变的活动性具有较高价值。
ObjectiveTo evaluate the value of 3.0 T dynamic contrast-enhanced magnetic resonance imaging（MRI） in the diagnosis of hip joint lesions in patients with ankylosing spondylitis （AS）.MethodsFifty-two AS patients with hip involvement were diagnosed in Department of Rheumatology in our hospital from January 2013 to December 2016. All patients underwent AS disease activity ankylosing spondylitis disease activity score （ASDAS）-C-reactive protein （CRP） score evaluation of hip joint acti-vity and hip joint disease activity was evaluated by doctors. According to ASDAS-CRP score, patients were divided into active disease 34 cases and remission for 18 cases. All patients underwent double hip MRI plain scan, dynamic enhanced scan and post-processing analysis after the diagnosis. Six regions of interest were selected in the abnormal synovial area around the hip joint. The time signal TIC curve was generated automatically, the shape of the curve was described and the early intensification rate of the third, fourth phase was measured. The early intensification rates of the active disease group and the remission group were analyzed statistically. Two independent samples t test was used for analysis, and P〈0.05 was regarded as statistically significant. The early intensification rate of the third, fourth phase were compared with the ASDAS-CRP score, the evaluation of hip joint activity in patients and the evaluation of hip joint activity were carried out by doctors taking care of the patients.ResultsThe TIC curve of the active group was rising fast, followed by platform or fast rising. The curve of the remission group was slow rising. The inten-sification rate of the third, fourth phase [（116±9）%, （146±12）% respectively] in the active phase group was higher than that of the remission group [（23±5）%, （43±14）%], and the difference was statistically significant （t=2.447, 3.054; P〈0.05）. The rate of synovial enhancement of the third, fourth phases was positively correlated with the ASDAS-CRP score （r=0.802, 0.836, P=0.01）, and the correlation was poor with evaluation of hip joint activity by patients （r=0.352, 0.458; the P=0.02, 0.01 respectively）, and the correlation was goodwith the evaluation of hip joint activity by doctors （r=0.652, 0.717; P=0.01）.ConclusionThe shape and early enhancement rate of magnetic reson-ance dynamic enhanced TIC curve is valuable in assessing the disease activity of hip joint lesions in AS patients.
作者
傅丽晖
张瑾
梁良
Fu Lihui;Zhang Jin;Li＇ang liang(Department of Radiology,Ningbo Lihuili Hosptial,Zhejiang 315041,China)
出处
《中华风湿病学杂志》
CAS
CSCD
北大核心
2018年第7期459-463,共5页
Chinese Journal of Rheumatology
关键词
脊柱炎
强直性
磁共振成像
髋关节
关节炎疾病活动度
Ankylosing spondylitis
Magnetic resonance imaging
Hip joint
Ankylosing spondylitis disease activity score
