本文選題：強直性脊柱炎 + 骶髂關(guān)節(jié)炎��； 參考：《川北醫(yī)學(xué)院》2017年碩士論文

【摘要】：目的:探討體素內(nèi)不相干運動擴散加權(quán)成像(intravoxel incoherent motion diffusion-weighted imaging,IVIM-DWI)診斷強直性脊柱炎(Ankylosing Spondylitis,AS)活動性骶髂關(guān)節(jié)炎的可行性及價值。材料與方法:隨機收集川北醫(yī)學(xué)院附屬醫(yī)院2016年5月至2017年2月風(fēng)濕免疫科門診及住院符合診斷標準的AS病人,共49例。實驗組根據(jù)ESR,CPR,Bath強直性脊柱炎病情活動指數(shù)(BASDAI)分為活動期組和穩(wěn)定期組。其中活動組21例,穩(wěn)定組28例。對照組為28名健康志愿者。參照FS-T2WI及高b值(b=800s/mm~2)時的DWI圖像來觀察病灶,在圖像后處理工作站DWI圖像上放置ROI進行數(shù)據(jù)測量。記錄純水分子擴散系數(shù)(D),灌注相關(guān)的偽擴散系數(shù)(D*)以及灌注分數(shù)(f),采用單因素方差分析三組D、D*、f。采用Mann-Whitney U檢驗分析穩(wěn)定組及活動組間的年齡、BASDAI評分、ESR及CRP。繪制ROC,比較各參數(shù)值的AUC以評定其診斷效能。結(jié)果:1、穩(wěn)定組與活動組間的年齡差異無統(tǒng)計學(xué)差異(p0.05),活動組BASDAI評分、ESR及CRP高于穩(wěn)定組,有統(tǒng)計學(xué)差異意義(p0.05)。2、IVIM參數(shù):活動組D、D*、f值分別為(0.72±0.29)×10~(-3)mm~2/s、(5.79±3.58)×10~(-3)mm~2/s、(13.56±5.46)%;穩(wěn)定組D、D*、f值分別為(0.35±0.16)×10~(-3)mm~2/s、(4.38±2.48)×10~(-3)mm~2/s、(9.68±3.18)%;對照組D、D*、f值分別為(0.29±0.08)×10~(-3)mm~2/s、(3.94±2.88)×10~(-3)mm~2/s、(10.38±4.23)%。結(jié)果顯示三組間D值差異有統(tǒng)計學(xué)意義(p0.05)�；顒咏MD*值高于穩(wěn)定組、對照組,且差異有統(tǒng)計學(xué)意義(p0.05);穩(wěn)定組與對照組間D*值差異無統(tǒng)計學(xué)意義(p0.05)�；顒咏Mf值高于穩(wěn)定組、對照組,且差異有統(tǒng)計學(xué)意義(p0.05);穩(wěn)定組與對照組間f值差異無統(tǒng)計學(xué)意義(p0.05)。3、ROC曲線:比較D、D*、f值在三組間的AUC,D值的AUC最大,其敏感性及特異性最高�；顒咏M與穩(wěn)定組間臨界值(AUC、敏感性、特異性)為D=0.42×10~(-3)mm~2/s(0.870、83.80%、74.80%);活動組與對照組間臨界值(AUC、敏感性、特異性)分別為D=0.38×10~(-3)mm~2/s(0.923、89.20%、85.30%)。結(jié)論:IVIM-DWI能有效、無創(chuàng)地反映AS活動期骶髂關(guān)節(jié)炎水分子擴散及微循環(huán)灌注狀態(tài),D值、D*值及f值有助于對AS活動性的診斷,其中D值的診斷效能最高。
[Abstract]:Objective: to investigate the feasibility and value of intravoxel incoherent motion diffusion-weighted imaging IVIM-DWI in the diagnosis of active sacroiliac arthritis in ankylosing spondylitis (ASA). Materials and methods: 49 patients with as who met the diagnostic criteria in the Department of Rheumatological Immunology from May 2016 to February 2017 in affiliated Hospital of North Sichuan Medical College were randomly collected. The experimental group was divided into active group and stable group according to the disease activity index of Bath ankylosing spondylitis. There were 21 cases in active group and 28 cases in stable group. The control group consisted of 28 healthy volunteers. The lesions were observed by referring to the DWI images of FS-T2WI and high b value of 800 s / mm ~ 2. ROI was placed on the DWI images of the image post-processing workstation to measure the data. The pure water molecular diffusion coefficient (DX), the perfusion related pseudo-diffusion coefficient (DX) and the perfusion fraction (FG) were recorded. The single factor analysis of variance (ANOVA) was used in three groups. Mann-Whitney U test was used to analyze the age and age of stable group and active group. Draw ROCand compare the AUC of each parameter value to evaluate its diagnostic efficiency. 緇撴灉:1,紼沖畾緇勪笌媧誨姩緇勯棿鐨勫勾榫勫樊寮傛棤緇熻瀛﹀樊寮，

本文編號：1810590