标题：多模态MRI成像评估强直性脊柱炎髋关节病变炎性活动的价值

      作者：张艳辉 1，2，屈小春 2，窦科妮 2，刘耀飞 2    1.商丘医学高等专科学校医学技术学院，河南 商丘 476000；2.西安市第五医院影像科，陕西 西安 710082

      卷次： 2022年33卷16期

      【摘要】 目的 研究多模态磁共振成像(MRI)评估强直性脊柱炎(AS)髋关节病变炎性活动的价值。方法 回顾性分析2020年3月至2021年5月西安市第五医院收治的120例AS患者的临床资料，根据髋关节病变情况分为病变组(n=86)和未病变组(n=34)，所有患者均行MRI检查，比较两组患者及不同炎性活动度患者的MRI检测结果，采用受试者工作特征曲线(ROC)分析检查结果对髋关节病变炎性活动的诊断价值，采用Spearman法分析多模态MRI检查参数与Bath AS疾病活动度(BASDAI)评分的相关性。结果 病变组患者的表观扩散系数(ADC)、容积转运常数(Ktrans)和速率常数(Kep)明显高于未病变组，差异均有统计学意义(P<0.05)；活动期AS髋关节病变患者的ADC值、Ktrans值和Kep值、BASDAI评分明显高于稳定期患者，差异均有统计学意义(P<0.05)；ADC值诊断AS患者髋关节病变炎性活动的效果最好，AUC为 0.826 (95%CI：0.729~0.899)，灵敏度最高(94.44%)；Ktrans值诊断的特异度最高(92.00%)；经Spearman法分析结果显示，AS髋关节病变患者的BASDAI评分与ADC值、Ktrans值呈正相关(r=0.670，0.543，P<0.05)。结论 多模态MRI检测能有效评估AS患者髋关节病变活动状态，且ADC值、Ktrans值与BASDAI评分有较强相关性 。
      【关键词】 多模态MRI成像；强直性脊柱炎；髋关节病变；炎性活动；表观扩散系数；容积转运常数；速率常数
      【中图分类号】 R684 【文献标识码】 A 【文章编号】 1003—6350（2022）16—2127—04

Value of multimodal magnetic resonance imaging in evaluating inflammatory activity of hip lesions in ankylosingspondylitis.
ZHANG Yan-hui 1, 2, QU Xiao-chun 2, DOU Ke-ni 2, LIU Yao-fei 2. 1. College of Medical Technology, ShangqiuMedical College, Shangqiu 476000, Henan, CHINA; 2. Department of Medical Imaging, the Fifth Hospital of Xi'an City,Xi'an 710082, Shaanxi, CHINA
【Abstract】 Objective To study the value of multimodal magnetic resonance imaging (MRI) in evaluating theinflammatory activity of hip joint lesions in ankylosing spondylitis (AS). Methods The clinical data of 120 patientswith AS admitted to the Fifth Hospital of Xi'an City between March 2020 and May 2021 were analyzed retrospectively.According to presence or absence of hip lesions, they were divided into lesion group (n=86) and non-lesion group (n=34). All patients underwent MRI examination. MRI results were compared between the two groups and among patientswith different inflammatory activities. The diagnostic value of the examination results for inflammatory activities ofhip lesions was analyzed by receiver operating characteristic (ROC) curves. The correlation between multimodal MRIparameters and score of Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) was analyzed by Spearmanmethod. Results The apparent diffusion coefficient (ADC), volumetric transport constant (Ktrans), and rate constant(Kep) in lesion group were significantly higher than those in non-lesion group, and the differences were statistically signif-icant (P<0.05). ADC, Ktrans and Kep values, and BASDAI scores in patients with active AS hip lesions were significantlyhigher than those in patients with stable AS hip lesions, and the differences were statistically significant (P<0.05). The di-agnostic efficiency of ADC value was the best for inflammatory activities of hip lesions in AS patients (AUC=0.826, 95%CI: 0.729 to 0.899), and its sensitivity was the highest (94.44% ). The diagnostic specificity of Ktrans was the highest(92.00%). Spearman analysis showed that BASDAI score of patients with AS hip joint lesions was positively correlatedwith ADC and Ktrans (r=0.670, 0.543, P<0.05). Conclusion Multimodal MRI detection can effectively evaluate the activ-ity status of hip lesions in AS patients. There is significant correlation between ADC, Ktrans and BASDAI score.
      【Key words】 Multimodal magnetic resonance imaging (MRI); Ankylosing spondylitis (AS); Hip lesion; Inflam-matory activity; Apparent diffusion coefficient; Volumetric transport constant; Rate constant