SMI在强直性脊柱炎患者骶髂关节炎的活动性及疗效评估中的应用研究
|
摘要
目的探讨微血流成像技术(SMI)在强直性脊柱炎(AS)患者骶髂关节(SIJ)炎的活动性及疗效评估中的应用价值。方法用SMI检查30例活动期AS患者、30例健康志愿者共120个SIJ,对比病例组与对照组滑膜血流的显示率、血流丰富程度及血流阻力指数(RI)的差异,并将治疗后病情缓解的11例患者治疗前后的血流指标、血沉、C反应蛋白及BASDAI评分作对比分析。结果病例组与对照组的SIJ血流显示率、丰富程度及RI值差异均有统计学意义(P<0.05),病例组以多血流为主,对照组以少血流为主,病例组RI值较健康志愿者低;治疗前后的RI、血沉、C反应蛋白、BASDAI评分均有统计学的差异(P<0.05)。结论 1)SMI的血流丰富程度及RI值可为判断AS患者SIJ炎的活动性提供重要的参考依据;2)治疗后RI值较治疗前升高,RI值可作为评价疗效的有效指标,但血流丰富程度在判断治疗效果上价值不大。
Objective The aim of this study was to explore value of the application of superb microvascular imaging(SMI) for diagnosis and treatment of sacro-iliitis in ankylosing spondylitis. Methods 30 AS patients and 30 healthy volunteers were examined with SMI, a total of 120 SIJ. The differences of the depiction rate of blood flow, richness of synovial blood flow and resistance index(RI) were compared between the case group and the control group. Then, 11 cases of AS patients with remission after treatment were examined by SMI, the blood flow, clinical and laboratory indexes before and after treatment were compared. Results There was a significant difference in the rate of blood flow, richness and RI of sacroiliac joint of the AS patients and healthy volunteers of the SMI blood flow patterns(P<0.05). In the AS patients,the majority of the blood flow was 2～3 level, while the healthy volunteers was dominated by the blood flow of the 0～1 level. The mean RI in the patient group was 0.57±0.07, and the blood flow was mainly low resistance. The mean RI in the control group was 0.67±0.07. There were significant differences in RI, ESR, CRP and BASDAI Score before and after treatment(P<0.05). Conclusion The blood flow rihness and RI values of SMI can provide important reference basis for judging the activity of SIJ inflammation in AS patients. RI value increases after treatment compared with that before treatment. RI value can be used as an effective indicator to evaluate the efficacy, but the degree of blood flow abundance is of little value in judging the treatment effect.
Objective The aim of this study was to explore value of the application of superb microvascular imaging(SMI) for diagnosis and treatment of sacro-iliitis in ankylosing spondylitis. Methods 30 AS patients and 30 healthy volunteers were examined with SMI, a total of 120 SIJ. The differences of the depiction rate of blood flow, richness of synovial blood flow and resistance index(RI) were compared between the case group and the control group. Then, 11 cases of AS patients with remission after treatment were examined by SMI, the blood flow, clinical and laboratory indexes before and after treatment were compared. Results There was a significant difference in the rate of blood flow, richness and RI of sacroiliac joint of the AS patients and healthy volunteers of the SMI blood flow patterns(P<0.05). In the AS patients,the majority of the blood flow was 2～3 level, while the healthy volunteers was dominated by the blood flow of the 0～1 level. The mean RI in the patient group was 0.57±0.07, and the blood flow was mainly low resistance. The mean RI in the control group was 0.67±0.07. There were significant differences in RI, ESR, CRP and BASDAI Score before and after treatment(P<0.05). Conclusion The blood flow rihness and RI values of SMI can provide important reference basis for judging the activity of SIJ inflammation in AS patients. RI value increases after treatment compared with that before treatment. RI value can be used as an effective indicator to evaluate the efficacy, but the degree of blood flow abundance is of little value in judging the treatment effect.
引文
[1] 陈辉,黄文起,褚爱鹏,等.强直性脊柱炎骶髂关节病变的CT、MRI表现[J].中国中西医结合影像学杂志,2014,12(4):441-442.
[2] Braun J,Van den Berg R,Baraliakos X,et al.2010 update of the ASAS/EULAR recommendations for the management of ankylosing spondylitis [J].Annals of the Rheumatic Diseases,2011,70(6):896-904.
[3] 金朝晖.强直性脊柱炎的影像诊断[J].中华现代影像学杂志,2009,6(10):649-651.
[4] 曾雪伟,黄华仪,李俊,等.X线、CT和MRI在早期强直性脊柱炎骶髂关节病变诊断中的价值比较[J].中国实用医药,2017,12(10):44-46.
[5] 周翠翠,吴锐,张卫平,等.彩色多普勒超声评价中轴型脊柱关节病骶髂关节血流信号[J].中国医学影像技术,2016,32(1):121-124.
[6] 刘越,赵艳梅,夏群.强直性脊柱炎的诊断与治疗进展[J].中国矫形外科杂志,2015,23(3):235-238.
[7] Bonel HM,Boller C,Saar B,et al.Short-term changes in magnetic resonance imaging and disease activity in response to infliximab [J].Annals of the Rheumatic Diseases,2010,69(1):120-125.
[8] 宋习忠,韦素芹.早期强直性脊柱炎骶髂关节病变影像学检查临床分析[J].医学影像学杂志,2017,27(7):1415-1418.
[9] Yang ZH,Chen JY,Jiang XH,et al.Correlation between MR appearances of sacroiliac joint and inflammation activity in ankylosing spondylitis [J].Chinese Journal of Medical Imaging Technology,2011,27(1):158-161.
[10] Susanne Juhl Pedersen,Inge Juul Srensen,KayGeert A Hermann,et al.Responsiveness of the ankylosing spondylitis disease activity score (ASDAS) and clinical and MRI measures of disease activity in a 1-year follow-up study of patients with axial spondyloarthritis treated with tumour necrosis factor inhibitors [J].Annals of the Rheumatic Diseases,2010,69(6):1065-1071.
[11] 周翠翠,吴锐,张卫平,等.彩色多普勒超声评价中轴型脊柱关节病骶髂关节血流信号[J].中国医学影像技术,2016,32(1):121-124.
[12] 邹晋梅,杨静,漆家高,等.能量多普勒超声检查骶髂关节对早期强直性脊柱炎的诊断价值[J].现代诊断与治疗,2013,24(18):4081-4083.
[13] 王璐,陈莉.多普勒超声在早期活动性中轴型脊柱关节病中的应用[J].中国医学影像技术,2017,33(8):1256-1259.
[2] Braun J,Van den Berg R,Baraliakos X,et al.2010 update of the ASAS/EULAR recommendations for the management of ankylosing spondylitis [J].Annals of the Rheumatic Diseases,2011,70(6):896-904.
[3] 金朝晖.强直性脊柱炎的影像诊断[J].中华现代影像学杂志,2009,6(10):649-651.
[4] 曾雪伟,黄华仪,李俊,等.X线、CT和MRI在早期强直性脊柱炎骶髂关节病变诊断中的价值比较[J].中国实用医药,2017,12(10):44-46.
[5] 周翠翠,吴锐,张卫平,等.彩色多普勒超声评价中轴型脊柱关节病骶髂关节血流信号[J].中国医学影像技术,2016,32(1):121-124.
[6] 刘越,赵艳梅,夏群.强直性脊柱炎的诊断与治疗进展[J].中国矫形外科杂志,2015,23(3):235-238.
[7] Bonel HM,Boller C,Saar B,et al.Short-term changes in magnetic resonance imaging and disease activity in response to infliximab [J].Annals of the Rheumatic Diseases,2010,69(1):120-125.
[8] 宋习忠,韦素芹.早期强直性脊柱炎骶髂关节病变影像学检查临床分析[J].医学影像学杂志,2017,27(7):1415-1418.
[9] Yang ZH,Chen JY,Jiang XH,et al.Correlation between MR appearances of sacroiliac joint and inflammation activity in ankylosing spondylitis [J].Chinese Journal of Medical Imaging Technology,2011,27(1):158-161.
[10] Susanne Juhl Pedersen,Inge Juul Srensen,KayGeert A Hermann,et al.Responsiveness of the ankylosing spondylitis disease activity score (ASDAS) and clinical and MRI measures of disease activity in a 1-year follow-up study of patients with axial spondyloarthritis treated with tumour necrosis factor inhibitors [J].Annals of the Rheumatic Diseases,2010,69(6):1065-1071.
[11] 周翠翠,吴锐,张卫平,等.彩色多普勒超声评价中轴型脊柱关节病骶髂关节血流信号[J].中国医学影像技术,2016,32(1):121-124.
[12] 邹晋梅,杨静,漆家高,等.能量多普勒超声检查骶髂关节对早期强直性脊柱炎的诊断价值[J].现代诊断与治疗,2013,24(18):4081-4083.
[13] 王璐,陈莉.多普勒超声在早期活动性中轴型脊柱关节病中的应用[J].中国医学影像技术,2017,33(8):1256-1259.