超越结构和炎症的功能性磁共振成像——放射学轴性脊柱关节炎与腰椎蛋白聚糖耗竭相关。
Functional MR imaging beyond structure and inflammation-radiographic axial spondyloarthritis is associated with proteoglycan depletion of the lumbar spine.
作者信息
Abrar Daniel B, Schleich Christoph, Tsiami Styliani, Müller-Lutz Anja, Radke Karl Ludger, Holthausen Neela, Frenken Miriam, Boschheidgen Matthias, Antoch Gerald, Mucke Johanna, Sewerin Philipp, Braun Juergen, Nebelung Sven, Baraliakos Xenofon
机构信息
Department of Diagnostic and Interventional Radiology, University Düsseldorf, Medical Faculty, 40225, Düsseldorf, Germany.
Rheumazentrum Ruhrgebiet Herne, Ruhr University Bochum, Claudiusstr. 45, 44649, Herne, Germany.
出版信息
Arthritis Res Ther. 2020 Sep 17;22(1):219. doi: 10.1186/s13075-020-02312-x.
BACKGROUND
To compare the glycosaminoglycan (GAG) content of lumbar intervertebral disks (IVDs) of patients with ankylosing spondylitis (AS) and healthy volunteers and to investigate the association of GAG depletion and disease-related clinical and imaging features.
METHODS
Lumbar spines of 50 AS patients (mean age 50 ± 10.5 years) and 30 age-matched volunteers were studied with 3-T magnetic resonance imaging (MRI) and conventional radiographs (CR). The MRI protocol included high-resolution morphological sequences and the compositional GAG chemical exchange saturation transfer imaging technique (gagCEST). Morphological images were analyzed by three raters for inflammatory activity, fat deposition, disk degeneration, and structural changes on CR. Clinical and serological measures included the Bath AS Disease Activity (BASDAI) and Bath AS Function (BASFI) Indices and C-reactive protein (CRP) levels. GagCEST values of both groups were compared using a linear mixed model. Kendall-Tau correlation analyses were performed.
RESULTS
GagCEST values were significantly lower in AS patients (2.0 ± 1.7%) vs. healthy volunteers (2.4 ± 1.8%), p = 0.001. Small, yet significant correlations were found between gagCEST values and CRP levels (τ = - 0.14, p = 0.007), BASFI (τ = - 0.18, p < 0.001) and presence of syndesmophytes (τ = - 0.17, p = 0.001). No significant correlations were found with BASDAI, inflammation, and fat deposition MRI scores.
CONCLUSIONS
Lumbar spines of r-AS patients undergo significant GAG depletion, independently associated with syndesmophyte formation, functional disability, and increased serological inflammation markers. Beyond establishing a pathophysiological role of the cartilage in AS, these findings suggest that gagCEST imaging may have an adjunct confirmatory role in the assessment of disease-related pathological MRI findings in axial spondyloarthritis.
TRIAL REGISTRATION
背景
比较强直性脊柱炎（AS）患者与健康志愿者腰椎间盘（IVD）中糖胺聚糖（GAG）的含量，并研究GAG耗竭与疾病相关临床和影像学特征之间的关联。
方法
对50例AS患者（平均年龄50±10.5岁）和30例年龄匹配的志愿者的腰椎进行3-T磁共振成像（MRI）和传统X线片（CR）检查。MRI检查方案包括高分辨率形态学序列和GAG化学交换饱和转移成像技术（gagCEST）。由三名评估人员对形态学图像进行分析，以评估CR上的炎症活动、脂肪沉积、椎间盘退变和结构变化。临床和血清学指标包括巴斯强直性脊柱炎疾病活动指数（BASDAI）、巴斯强直性脊柱炎功能指数（BASFI）和C反应蛋白（CRP）水平。使用线性混合模型比较两组的gagCEST值。进行肯德尔-陶相关性分析。
结果
AS患者的gagCEST值（2.0±1.7%）显著低于健康志愿者（2.4±1.8%），p = 0.001。发现gagCEST值与CRP水平（τ = -0.14，p = 0.007）、BASFI（τ = -0.18，p < 0.001）以及韧带骨赘的存在（τ = -0.17，p = 0.001）之间存在小而显著的相关性。未发现与BASDAI、炎症和脂肪沉积MRI评分有显著相关性。
结论
r-AS患者的腰椎经历了显著的GAG耗竭，这与韧带骨赘形成、功能障碍和血清学炎症标志物增加独立相关。除了确定软骨在AS中的病理生理作用外，这些发现表明gagCEST成像在评估轴性脊柱关节炎中与疾病相关的病理MRI表现方面可能具有辅助确认作用。
试验注册
Zotero 插件