| Objective1. Select the early patients with active ankylosing spondylitis, magnetic resonance measurement ADC value in DWI sequence sacroiliac joint surface marrow express microscopic lesions information from the molecular level, compared with the normal population differences. 2. dynamic contrast-enhanced magnetic resonance sequences(DCE-MRI) to draw the signal strength- time curve(TIC curve) and typing, calculating the enhancement factor Fenh, enhanced slope Senh and peak time Tmax values, a clear study population sacroiliac joint area the enhanced features and perfusion conditions. 3. To investigate the correlation between ADC values Fenh, Senh between values, perform a double to quantify the value of their combination of research, clinical improve early detection of patients with ankylosing spondylitis reference.MethodsUnder the revised New York standards, combined with clinical signs and symptoms and laboratory test results, retrospectively collected early clinical activity of 48 patients with ankylosing spondylitis, its sacroiliac joint MRI, including axial fast spin echo(FSE) T1 WI, T2 WI, oblique coronal fast inversion recovery sequence, diffusion-weighted imaging(DWI) and dynamic contrast-enhanced(DCE-MRI) examination. Check the video image will be imported GE MRAW4.6 workstation processing, analysis, sacroiliac joint diffusion-weighted image data, measurement of ankylosing spondylitis(AS) patients with active bilateral sacral side of the apparent diffusion coefficient iliac side of the bone marrow area(ADC) value, the lesion was obviously interested in directly at selected areas in the next three to take the average of the measurements at no obvious lesions, the mean comparison of a S patients and normal controls ADC value, using independent sample t-test( using SPSS13. 0 software) for its statistical analysis, P <0.05 explain the existence of statistically significant. Dynamic contrast-enhanced magnetic resonance sequences(DCE-MRI) to map out the signal strength of the study population bilateral sacral side, side iliac bone area- the time(TIC) curve, the lesion was obvious at a selected region of interest directly, no obvious lesions use a large area of the region of interest, try to contain the number of cortical bone, determine TIC curve type, by identifying, recording, or lesion area with a regional point of initial signal intensity(S0), enhance the signal maximum(Smax) and peak time(Tmax), calculate the enhancement factor Fenh and enhanced slope Senh, ankylosing spondylitis early lesions deterministic analysis, and clearly enhanced early AS patients with sacroiliac joint lesion characteristics and perfusion conditions. Take the same level( level 2 sacral holes) DWI sequences side measuring bilateral sacral iliac side of the ADC values of the four positions on, in the same position sequence enhanced computing Fenh and Senh, draw a scatter plot, explore their correlation.Results1. AS group under the sacroiliac joint surface area of bone marrow signal intensity : iliac side of the ADC average of(5.05 ± 1.10) × 10-4 mm2 / s, the sacral side of the ADC average of(4.63 ± 0.79) × 10-4 mm2 / s, sacrum, ADC value of the iliac bone area AS patients were higher than the normal control group, the difference between the two was statistically significant(P<0.05); ADC values of the mean(5.05 ± iliac side 1.10) compared to the sacral side of(4.63 ± 0.79) high. 2. 48 cases of patients with dynamic contrast enhanced MRI examination, they draw the bilateral iliac side TIC curve 96, Type II 68, III type 28; bilateral sacral side of the TIC curve 96, Type II 56, III type 40; no I-shaped curve. 3. AS group iliac bone area Fenh side was(113.38 ± 44.71)%, sacral side of(83.03 ± 20.39)%, AS group iliac bone area Senh side of(60.94 ± 38.56)% min, sacral side of( 44.91 ± 15.19)% min, AS group iliac side of the bone marrow area Tmax was(115.44 ± 22.46) s, the sacral side of the bone marrow area Tmax was(123.44 ± 28.50) s, iliac side 30, 48 of the sacral side of mild enhancement, 66 side of the iliac and sacral side of the 48 severe hardening, different parts of the AS group and the control group( iliac side of the sacral side) from the semi- quantitative Fenh, the difference between Senh and Tmax values of groups with significant statistical significance(P < 0.05). 4. Scatter ADC values Fenh by the value of the lesion shows that there is a linear correlation(P = 0.000 <0.05) between lesion ADC values Fenh value lesion ADC values Fenh value of linear correlation coefficient r = 0.705, is highly relevant, positive correlation between lesion ADC values Fenh value. No ADC values between the lesion and Senh linear correlation between values(P = 0.265> 0.05), lesion ADC values Senh linear correlation coefficient value r = 0.207, for the low correlation.ConclusionsMagnetic resonance diffusion weighted imaging in patients with early sacroiliitis AS marrow abnormalities reveal sensitive. ADC values in patients with early bone marrow under the sacroiliac joint surface area greater than the normal group, patients with active calculated Fenh, Senh greater than the normal control group, Tmax less than the normal group, indicating lower articular surface of bone marrow activity and capillary zone early in the disease in an increase in the number of blood vessels and sinuses, increased vascular permeability, perfusion acceleration. MRI-DWI and DCE-MRI of both joint, lesion ADC values associated with Fenh value, providing diagnostic imaging in patients with early bone marrow changing the face of the sacroiliac joints with active ankylosing spondylitis new ideas, making timely diagnosis and clinical interventions treatment, and provide reference for the evaluation of the effect of treatment. |
PDF Full Text Request