磁共振扩散加权成像在早期强直性脊柱炎中的应用

[Application of magnetic resonance diffusion weighted imaging in early ankylosing spondylitis].

作者信息

Ai Fei, Tian Dan, Zhang Wei, Li Xiao-ming, Wu Rao-pan, Xie Chuan-miao, Wu Pei-hong

机构信息

State Key Laboratory of Oncology in Southern China, Department of Medical Imaging & Interventional Radiology, Department of Gynecologic Oncology, Cancer Center, Sun Yat-sen University, Guangzhou 510060, China.

出版信息

Zhonghua Yi Xue Za Zhi. 2013 Mar 19;93(11):811-5.

PMID:23859384

Abstract

OBJECTIVE

To evaluate the magnetic resonance diffusion-weighted imaging (DWI) in the detection of early ankylosing spondylitis and explore the manifestations of ankylosing spondylitis on whole body DWI (WB-DWI).

METHODS

A total of 16 patients with early ankylosing spondylitis (AS) and 18 patients with low back pain (LBP) were recruited. Subchondral bone marrow apparent diffusion coefficient (ADC) in bilateral ilium and sacrum along sacroiliac joints were compared. An independent sample t-test (SPSS 16.0, SPSS, Chicago, III) was utilized to analyze the ADC value differences between groups. P < 0.05 denoted statistical significance. The mean ADC values of focal lesions in AS patients were also measured. Whole body diffusion weighted imaging was performed in additional 8 clinical confirmed AS patients and analyzed with the techniques of maximum intensity projection (MIP) and multiplanar reconstruction (MPR) in comparison with conventional MRI images to investigate the detectability of AS lesions with whole body DWI.

RESULTS

Mean ADC values in 16 AS patients were (0.51 ± 0.13)×10(-3)mm(2)/s in ilium and (0.49 ± 0.17)×10(-3)mm(2)/s in sacrum. Mean ADC values in 18 LBP patients were (0.32 ± 0.06)×10(-3)mm(2)/s in ilium and (0.31 ± 0.08)×10(-3)mm(2)/s in sacrum. The ADC value in AS patients were statistically significantly greater than those in ilium and sacrum of LBP patients. Whole body DWI detected abnormalities in 8 AS patients within bilateral sacroiliac joints and other sites corresponding to the clinical symptoms of patients. The mean ADC values of focal lesions of this patient cohort were (1.31 ± 0.38)×10(-3)mm(2)/s in sacrum and (1.18 ± 0.27)×10(-3)mm(2)/s in ilium.

CONCLUSION

Subchondral marrow ADC values along sacroiliac joints allow the differentiation of patients with early AS from LBP patients. In conjunctions with such post-processing techniques as MIP and MPR, WB-DWI allows a comprehensive assessment of AS patients to guide treatment, evaluate prognosis and follow therapeutic responses.

摘要

目的

评估磁共振扩散加权成像（DWI）在早期强直性脊柱炎检测中的应用，并探讨强直性脊柱炎在全身DWI（WB-DWI）上的表现。

方法

共纳入16例早期强直性脊柱炎（AS）患者和18例腰痛（LBP）患者。比较双侧髂骨和沿骶髂关节的骶骨软骨下骨髓表观扩散系数（ADC）。采用独立样本t检验（SPSS 16.0，SPSS，芝加哥，伊利诺伊州）分析两组间ADC值差异。P < 0.05表示具有统计学意义。还测量了AS患者局灶性病变的平均ADC值。对另外8例临床确诊的AS患者进行全身扩散加权成像，并与传统MRI图像相比，采用最大强度投影（MIP）和多平面重建（MPR）技术进行分析，以研究全身DWI对AS病变的检测能力。

结果

16例AS患者髂骨的平均ADC值为（0.51±0.13）×10⁻³mm²/s，骶骨为（0.49±0.17）×10⁻³mm²/s。18例LBP患者髂骨的平均ADC值为（0.32±0.06）×10⁻³mm²/s，骶骨为（0.31±0.08）×10⁻³mm²/s。AS患者的ADC值在统计学上显著高于LBP患者的髂骨和骶骨ADC值。全身DWI在8例AS患者的双侧骶髂关节及与患者临床症状相对应的其他部位检测到异常。该患者队列局灶性病变的平均ADC值在骶骨为（1.31±0.38）×10⁻³mm²/s，在髂骨为（1.18±0.27）×10⁻³mm²/s。