DWI在强直性脊柱炎活动期诊断中的应用.doc

山西医科大学硕士学位论文 关键词：强直性脊柱炎；磁共振成像；弥散加权成像；表观扩散系数 The Evaluation of Diffusion Weighted Imaging in activity of ankylosing spondylitis Abstract Magnetic resonance imaging(MRI) of the sacroiliac(SI) joints has rapidly gained attention as a potentially useful imaging modality in the diagnostic process of patients. Many reports has been described that MR imaging is superior to plain radiographs and CT for the early diagnosis of sacroiliitis. However, Role of DWI in the diagnosis of ankylosing spondylitis is rare. The purpose of our study was to determine whether DWI can be used to differentiate AS activity from chronic. Methods X-Radiology、 MRI、DWIwere performed in 21 patients and 13 normal control. Radiographs of sacroiliac joints were graded by consensus of two musculoskeletal radiologists according to the modified New York criteria for ankylosing spondylitis; grades 0:29 cases; gradesⅠ-Ⅱ:7 cases; gradesⅢ-Ⅳ:6 cases. Diagnosis of MRI grades 0:8 cases; gradesⅠ-Ⅱ:16 cases; gradesⅢ-Ⅳ:18 cases. The ADC calculated, and their threshold of differential normal control and AS activity or chronic were affirmed with receiver operating characteristic (ROC), area under ROC was calculated as well. The sensitivity, specificity of diagnosing normal control and AS activity or chronic by both DWI were also studied. Results : the ADC values control and AS activity were 0.444±0.029×10-3mm2/s and 1.123±0.109×10-3mm2/s respectively (P=0.000), area under ROC was 1, the threshold value of rADC is 0.713, with the sensitivity, specificity as 100%, 100%. The ADC values chronic and AS activity were0.380±0.043×10-3mm2/s and 1.123±0.109×10-3mm2/s respectively (P=0.000), area under ROC was 1, the threshold value of rADC is 0.684, with the sensitivity, specificity as 100%, 100% . DWI can significantly improve the AS activity and chronic diagnostic pecificity and sensitivity. [KEY WORDS] ankylosing spondylitis, Magnetic resonance imaging, diffusion weighted imaging, apparent diffusion coefficien II 山西医科大学硕士学