目的:确定T2*软骨标测在诊断和评估早期轴向脊柱关节炎(axSpA)疾病活动中的性能,并探讨软骨损伤与临床特征的相互作用,骶髂关节炎MRI评分,和扩散指标。
方法:这项前瞻性研究包括83名axSpA患者和37名非axSpA患者。临床特征,在MRI上评估国际社会定义的活动性骶髂关节炎,并记录T2*SIJs值。在axSpA中,使用强直性脊柱炎疾病活动评分-C反应蛋白评估疾病活动;使用加拿大关节炎研究协会评估活动性骶髂关节炎,体素内不连贯运动,和弥散峰度成像;使用复合结构损伤评分(CSDS)和结构评分脂肪评估慢性骶髂关节炎。Mann-WhitneyU-test,具有错误发现率(FDR)的Kruskal-Wallis测试,ROC曲线,采用线性回归进行统计分析。
结果:AxSpA患者的T2*SIJs值明显高于非axSpA患者。(22.86±2.42msvs20.36±1.30ms,p<0.001)。MRI上T2*SIJs值和活动性骶髂关节炎的组合具有用于鉴定axSpA的最高AUC。T2*SIJs值在非活跃和非常高之间有显著差异,中等和非常高,又高又高,以及不活跃和高疾病活动度组(所有pFDR<0.05)。Dk(β=0.48)和CSDS(β=0.48)与T2*SIJs值独立相关。
结论:T2*值可能是诊断和区分axSpA早期疾病活动的有希望的生物标志物。急性和慢性骶髂关节炎都会影响软骨特性。
结论:骶髂关节软骨异常可以通过T2*弛豫时间来量化,并可以更好地表征早期axSpA。
结论:T2*作图可能对评估axSpA有价值。MRI上T2*值和活动性骶髂关节炎的组合增强了axSpA的诊断性能。用T2*值测量的异常与疾病活动相关,急性骶髂关节炎,和结构损伤程度。
OBJECTIVE: To determine the performance of T2* cartilage mapping in diagnosing and assessing disease activity in early axial spondyloarthritis (axSpA), and to investigate the interaction of cartilage damage with clinical characteristics, sacroiliitis MRI scorings, and diffusion metrics.
METHODS: This prospective study included 83 axSpA patients and 37 no-axSpA patients. Clinical characteristics, the Assessment of SpondyloArthritis International Society-defined active
sacroiliitis on MRI, and T2* SIJs values were recorded. In axSpA, disease activity was evaluated using the ankylosing spondylitis disease activity score-C-reactive protein; active sacroiliitis was evaluated using Spondyloarthritis Research Consortium of Canada, intravoxel incoherent motion, and diffusion kurtosis imaging; chronic sacroiliitis was assessed using composite structural damage score (CSDS) and structural score fat. Mann-Whitney U-test, Kruskal-Wallis test with false discovery rate (FDR), ROC curve, and linear regression were used for statistical analysis.
RESULTS: AxSpA patients had significantly higher T2*SIJs values than no-axSpA patients. (22.86 ± 2.42 ms vs 20.36 ± 1.30 ms, p < 0.001). The combination of T2*SIJs values and active
sacroiliitis on MRI had the highest AUC for identifying axSpA. T2*SIJs values were significantly different between the inactive and very high, moderate and very high, high and very high, as well as inactive and high disease activity groups (all pFDR < 0.05). Dk (β = 0.48) and CSDS (β = 0.48) were independently associated with T2*SIJs values.
CONCLUSIONS: T2* values may be a promising biomarker for diagnosing and differentiating disease activity in early axSpA. Both acute and chronic
sacroiliitis influence cartilage properties.
CONCLUSIONS: Sacroiliac joint cartilage abnormalities can be quantified with T2* relaxation time and allow better characterization of early axSpA.
CONCLUSIONS: T2* mapping may have value in evaluating axSpA. The combination of T2* values and active
sacroiliitis on MRI enhances diagnostic performance for axSpA. Abnormalities measured with T2* values correlate with disease activity, acute
sacroiliitis, and degree of structural damage.