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Radiology:MRI表观扩散系数在评价中轴型脊柱关节炎炎性反应的价值

2019-03-02 shaosai MedSci原创

现如今尚无对中轴型脊柱关节炎(SpA)活动性炎性病变定量评价的影像学方法。前期研究表明扩散加权(DW)MRI能够反映中轴型SpA的炎性反应。

现如今尚无对中轴型脊柱关节炎(SpA)活动性炎性病变定量评价的影像学方法。前期研究表明扩散加权(DW)MRI能够反映中轴型SpA的炎性反应。

本研究旨在评价椎间盘椎体病变MRI表观扩散系数(ADC)与中轴型SpA炎性活动的相关性。

本前瞻性研究共纳入了243例表现为后背痛并完成SpA脊柱关节炎国际学会诊断标准的受试者,其中男性132例(平均年龄为41.4 years ± 13.3),女性111例(平均年龄为45.3 years ± 13.4)。收集临床、生物化学和放射学指标。所有受试者行全脊柱短反转时间反转恢复序列和DW成像扫描。由两名放射科医生独立评价有无椎间盘椎体病变。测量ADC值并通过正常骨髓ADC值进行校准。利用回归分析评价椎间盘椎体病变平均ADC、最大ADC、校正后平均ADC和校正后最大ADC值与炎症活动性、功能指标(Bath强直性脊柱炎疾病活性指数[BASDAI]、Bath强直性脊柱炎功能指数[BASFI]和Bath强直性脊柱炎整体指数[BASGI])的相关性。

结果为,共有55/243例受试者(22.6%)出现91处椎间盘椎体病变(颈椎5处,胸椎61处,腰椎25处)。经调整混杂变量后,最大ADC值增高与BASFI增高具有独立相关性(回归系数[β] = 1.94 [×10-3 mm2/sec], P = .04)。校正后最大ADC值增高与BASDAI问题2(例如后背痛评分)(β = 0.45, P = .01)、平均僵硬评分(β = 0.41, P = .04)、BASGI (β = 0.43, P = .04)具有独立相关性。校正后平均ADC值增高与BASDAI问题2具有独立相关性(β = 0.61, P = .04)。

本研究表明,椎间盘椎体病变MRI表观扩散系数与中轴型脊柱关节炎病变炎性活动、功能受损和患者整体评分具有相关性。

研究表明,在进行相似的头球后,女性要比男性出现更多的颅脑白质微小结构改变,这表明在经历重复性创伤后不同性别间具有颅脑生物性差异。

原始出处:

Lee KH, Chung HY, Xu X,et al.Apparent Diffusion Coefficient as an Imaging Biomarker for Spinal Disease Activity in Axial Spondyloarthritis.Radiology.DOI:10.1148/radiol.2019180960

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