本文選題：骶髂關(guān)節(jié)炎 + 磁共振成像��； 參考：《放射學(xué)實(shí)踐》2017年09期

【摘要】：目的:探討DWI、DCE-MRI診斷骶髂關(guān)節(jié)(SIJ)急性炎癥的價(jià)值。方法:選取42例骶髂關(guān)節(jié)炎患者及18例志愿者(對(duì)照組),對(duì)所有60例受檢者行雙側(cè)骶髂關(guān)節(jié)MR平掃、動(dòng)態(tài)增強(qiáng)MRI(DCE-MRI)及擴(kuò)散加權(quán)成像(DWI)檢查。根據(jù)TIRM-T2WI序列上骨髓信號(hào)是否增高將42例患者分為急性炎癥組(18例)和非急性炎癥組(24例)。對(duì)急性炎癥組患者進(jìn)行SPARCC評(píng)分。描繪時(shí)間-信號(hào)曲線(TIC)并對(duì)其進(jìn)行分型;計(jì)算、測(cè)量各組骨髓區(qū)的增強(qiáng)因子(Fenh)、增強(qiáng)斜率(Senh)及表觀擴(kuò)散系數(shù)(ADC)值。并對(duì)急性炎癥組患者的SPARCC評(píng)分、ADC值及Fenh三者間進(jìn)行相關(guān)性分析。結(jié)果:急性炎癥組SPARCC評(píng)分為(21.06±7.20)分。TIRM-T2WI、DWI及DCE-MRI分別檢出35、34、36側(cè)關(guān)節(jié)面下急性炎癥,三者間檢測(cè)能力差異無(wú)統(tǒng)計(jì)學(xué)意義(χ2=2.06,P0.05)。急性炎癥組病變區(qū)ADC值、Fenh及Senh均高于非急性炎癥組、對(duì)照組,差異均有統(tǒng)計(jì)學(xué)意義(F值分別為381.591、62.080、11.097,P值均0.01);非急性炎癥組與對(duì)照組上述三個(gè)參數(shù)間差異無(wú)統(tǒng)計(jì)學(xué)意義(P值均0.05)。急性炎癥組TIC表現(xiàn)為快速上升平臺(tái)型(72.22%)和持續(xù)快速上升型(27.78%);非急性炎癥組和對(duì)照組TIC均表現(xiàn)為速升緩降型。急性炎癥組的SPARCC評(píng)分與ADC值、SPARCC評(píng)分與Fenh、ADC值與Fenh均呈正相關(guān)(r值分別為0.874、0.673、0.723,P值均0.05)。結(jié)論:DWI、DCE-MRI檢出SIJ急性炎癥的能力相當(dāng);通過(guò)計(jì)算ADC值、Fenh及Senh可對(duì)炎性病變程度進(jìn)行量化評(píng)價(jià),DWI、DCE-MRI對(duì)SIJ急性炎癥的診斷具有重要價(jià)值。
[Abstract]:Objective: to evaluate the value of DWI DCE-MRI in the diagnosis of acute inflammation of sacroiliac joint (SIJ).Methods: a total of 42 patients with sacroiliac arthritis and 18 volunteers (control group) were examined with Mr plain scan, dynamic contrast enhanced Mr imaging (DCE-MRI) and diffusion weighted imaging (DWI) of bilateral sacroiliac joint.According to TIRM-T2WI sequence, 42 patients were divided into acute inflammation group (n = 18) and non-acute inflammation group (n = 24).The patients in acute inflammation group were assessed with SPARCC.The time-signal curve (TIC) was described and classified, and the enhancement factor (Fenhan), enhanced slope (Senhan) and apparent diffusion coefficient (ADCC) of bone marrow area in each group were measured.The correlation between SPARCC score and Fenh in acute inflammation group was analyzed.Results: the SPARCC score of acute inflammation group was 21.06 鹵7.20. The acute subarticular inflammation was detected by TIRM-T2WIWI and DCE-MRI, respectively. There was no significant difference among the three groups (蠂 2. 06, P 0. 05).The values of ADC and Senh in the acute inflammation group were higher than those in the non-acute inflammation group, and in the control group, the difference was statistically significant (P = 381.591U, 62.080 / 11.097, P = 0.01), but there was no significant difference between the non-acute inflammation group and the control group in the above three parameters (P = 0.05).The TIC of acute inflammation group was 72.22) and that of continuous rapid rising type was 27.78%, and that of non-acute inflammation group and control group was rapid ascending and slowly descending type.In acute inflammation group, the SPARCC score and ADC value, SPARCC score, Fenhan ADC value and Fenh were positively correlated with Fenh, the r values were 0.874 鹵0.673 鹵0.723 (P = 0.05), respectively.Conclusion the ability of DCE-MRI to detect acute inflammation of SIJ is equal to that of DCE-MRI, and it is important to evaluate the degree of acute inflammation of SIJ by calculating ADC value and Senh.
【作者單位】： 青島大學(xué)附屬煙臺(tái)毓璜頂醫(yī)院影像科磁共振室;
【基金】：煙臺(tái)市重點(diǎn)研發(fā)計(jì)劃項(xiàng)目(2016ws026)
【分類號(hào)】：R445.2;R684.3

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