T1-mapping与RESOLVE DWI在中轴型脊柱关节炎骶髂关节炎症活动性定量评估中的比较研究OA

Objective:This study compares the diagnostic efficacy of T1-mapping and readout segmentation of long variable echo-train diffusion-weighted imaging(RESOLVE DWI)techniques in quantitatively assessing sacroiliac joint inflammation activity levels in axial spondyloarthropathy(axSpA),aiming to provide clinicians with more valuable quantitative indicators.Materials and Methods:The retrospective cohort study included 74 patients diagnosed with axial spondyloarthropathy(axSpA)at the Department of Rheumatology,Provincial Hospital Affiliated to Fuzhou University between June 2017 and June 2024,forming the case group.A control group comprised 19 individuals who underwent sacroiliac joint MRI examinations for mechanical low back pain.Within the case group,participants were further categorised into an active group(n=40)and an inactive group(n=34)based on the Ankylosing Spondylitis Disease Activity Score(ASDAS).All research subjects underwent conventional MRI,T1-mapping,and RESOLVE DWI quantitative technical inspection.T1-mapping values and apparent diffusion coefficient(b=50,500,700 s/mm2,denoted as ADC50,500,700)of the subchondral bone marrow in the sacroiliac joints were measured simultaneously across both groups.Comparisons were made between the control group,case group,and its subgroups(inactive and active groups)regarding differences in T1-mapping values and ADC50,500,700 values.The diagnostic efficacy of T1-mapping and ADC50,500,700 across groups was analysed using receiver operating characteristic(ROC)curves,and the area under the curve(AUC)was calculated.The DeLong test was used to compare the differences in AUC values between the two groups.Results:The T1-mapping values and ADC50,500,700 values of the subchondral bone marrow in the sacroiliac joint were higher in the case group,inactive group,and active group than in the control group(P＜0.001 for all comparisons).The T1-mapping values and ADC50,500,700 values of the subchondral bone marrow in the sacroiliac joint of the active group were higher than those in the inactive group(P＜0.05).In distinguishing the control group from the case group,the AUC values for T1-mapping and ADC50,500,700 were 0.889 and 0.877 respectively;when differentiating the control group from the inactive group,the AUC values were 0.811 and 0.828 respectively.In distinguishing the control group from the active group,the AUC values were 0.955 and 0.918 respectively,both demonstrating good diagnostic performance.The Delong test indicated no statistically significant difference between them(all P＞0.05).When distinguishing between inactive and active groups,the AUC for T1-mapping was 0.808,whereas the AUC for ADC50,500.700 was 0.693,with a statistically significant difference(P=0.042).Conclusions:Both T1-mapping and RESOLVE DWI techniques effectively assess the level of sacroiliac joint inflammation activity in axial spondyloarthritis(axSpA).However,T1-mapping demonstrates superior efficacy in distinguishing between inactive and active groups among axSpA patients.