Clinical application of diffusion-weighted imaging and dynamic contrast-enhanced MRI in assessing the clinical curative effect of early ankylosing spondylitis

弥散加权成像和动态增强磁共振成像在评估早期强直性脊柱炎临床疗效中的临床应用

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Abstract

The study aimed to demonstrate the clinical application value of diffusion-weighted imaging (DWI) and dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) in assessing a clinical curative effect of early ankylosing spondylitis (AS).Forty-eight patients with early AS who were already treated combinations by traditional Chinese and Western medicine were involved in this study. All subjects underwent the conventional MRI, DWI, and DCE-MRI scanning of bilateral sacroiliac joints before and after treatment. The relevant data, such as the mean apparent diffusion coefficient (ADC) value, time-intensity curve of subarticular surface bone marrow, and the relationship between ADC value and enhancement factor (Fenh), enhancement slope (Senh), and time to peak (TTP), were obtained.1. The mean ADC value of the subarticular surface bone marrow of patients and after clinical treatment was (5.05 ± 1.10) × 10 and (4.34 ± 0.55) × 10 mm/s in ilium and (4.63 ± 0.79) × 10 and (3.96 ± 0.23) × 10 mm/s in sacrum, respectively. 2. In the DCE-MRI follow-up treatment imaging of 48 patients with AS (192 parts), the TIC curve type recorded was as follows: 43.75% (84/192) of type II, 56.25% (108/192) of type III, and type I curve was not seen. The number of type II curve was significantly reduced for pre treatment group (84 cases) compared with that post treatment group (124 cases). The Fenh, Senh, and TTP values were respective (113.38 ± 44.71)%, (60.94 ± 38.56)% min, (129.52 ± 42.66) s in ilium and (83.03 ± 20.39)%, (44.91 ± 15.19)% min, (123.44 ± 28.50) s in sacrum before clinical treatment. After the treatment, the Fenh, Senh, and TTP values were respective (75.90 ± 17.97)%, (33.96 ± 11.36)% min, (138.67 ± 26.60) s in ilium and (73.28 ± 15.67)%, (31.92 ± 8.15)% min, (140.19 ± 19.88) s in sacrum. The Fenh, Senh, and TTP values of semiquantitative indexes before and after clinical treatment were significantly different.DWI and DCE-MRI sequences can help evaluate the degree of active changes in AS inflammation and treatment effect in patients with early AS, and provide reliable imaging evidence.

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