MRI功能成像对强直性脊柱炎的疗效评价△

Efficacy evaluation of MRI functional imaging for ankylosing spondylitis

摘要:

[目的] 探讨 MRI 功能成像对早期强直性脊柱炎 (ankylosing spondylitis, AS) 骶髂关节炎的疗效的评估价值。[方法]回顾 48 例 AS 患者，经中西药综合治疗半年前后临床检验指标与骶髂关节 MRI 平扫指标，包括 BASDAI 评分、CRP、ESR 以及 STIR 获得 SPARCC 评分和通过 IVIM 获得评价指标。分析治疗前后临床检验与 MRI 指标变化及相关性。[结果]与治疗前相比，治疗后 BASDAI 评分、ESR、CRP、SPARCC 评分、ADC_slow 和 f 值均显著降低 (P＜0.05)；而 ADC_fast 无显著变化 (P＞ 0.05)。SPARCC 评分和 ADC_slow与 BASDAI 评分和 CRP 呈高度相关性(P＜0.05)，与 ESR 中度相关性(P＜0.05)；f 值与 BASDAI 评分、CRP、ESR 呈中、低度相关 (P＜0.05)；ADC_fast 与 BASDAI 评分、ESR 和 CRP 无明确相关性。[结论] MRI 功能成像 SPARCC 评分和 ADC_slow、f 值可能有效评估 AS 骶髂关节炎的治疗效果。

Abstract:

[Objective] To explore the efficacy of MRI functional imaging used for evaluation of early ankylosing spondylitis (AS) sacro- iliac arthritis. [Methods] A total of 48 patients who received comprehensive treatment with Chinese and Western medicine for AS were re- viewed. The clinical score, laboratory tests and MRI parameters were collected and compared, including BASDAI score, CRP, ESR, STIR, and parameters of MRI IVIM, additionally, correlations among the clinical score, laboratory tests and imaging data were searched. [Results] Compared with those before treatment, the BASDAI score, ESR, CRP, SPARCC score, ADC_slow and f value significantly decreased after treatment (P<0.05) , whereas the ADC_fast remained unchanged (P>0.05) . In term of relationship, the SPARCC score and ADC_slow were high- ly correlated with BASDAI score and CRP (P<0.001) , moderately correlated with ESR (P<0.05) . In addition, there was a moderate and low correlation of f value with BASDAI score, CRP and ESR (P<0.05) , however, there was no clear correlation of ADC_fast with BASDAI score, ESR and CRP. [Conclusion] MRI functional imaging items, such as SPARCC score, ADC_slow and f value might be effective in evaluating the therapeutic outcomes of AS sacroiliac arthritis.