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[目的]探讨磁共振DWI、DCE序列对评价中西医结合治疗早期强直性脊柱炎疗效的应用价值。[方法]随访前期研究中的48例(男38例、女10例)确诊为早期AS并经中西医治疗的患者,通过磁共振DWI及DCE扫描,获取治疗后关节面下骨髓ADC平均值,绘制TIC曲线,计算Fenh、Senh值及达峰时间Tmax值,与前期研究所获取治疗前相应数据进行统计学分析比对。[结果]经临床治疗的患者骶髂关节面下骨髓区ADC平均值:髂骨侧为(4.34±0.55)×10-4mm2/s,骶骨侧为(3.96±0.23)×10-4mm2/s,均较治疗前减低,组间差距具有显著统计学意义。半定量指标Fenh、Senh均较对照组明显减低,Tmax高于对照组,差异具有统计学意义。骶髂关节骶、髂侧ADC值与Fenh值间呈高度正相关关系(P<0.05),髂侧ADC值与Senh呈高度正相关关系(P<0.05)。[结论]磁共振DWI及DCE序列可用于评价AS炎症活动程度变化,反映早期AS患者的治疗疗效,并可为临床疗效提供可靠的影像学依据。
[Objective] To investigate the value of magnetic resonance DWI and DCE sequences in evaluating the curative effect of integrated traditional Chinese and western medicine on early ankylosing spondylitis. [Methods] Forty-eight patients (38 males and 10 females) diagnosed as early stage AS and treated by TCM and Western medicine were studied in the previous follow-up study. The average ADC value of bone marrow under the articular surface was obtained by DWI and DCE scanning after magnetic resonance TIC curves were plotted, Fenh, Senh values and peak time Tmax values were calculated, and compared with previous data obtained before treatment for statistical analysis and comparison. [Results] The average ADC value of the bone marrow area under the sacroiliac joint in the clinically treated patients was (4.34 ± 0.55) × 10-4mm2 / s on the iliac side and (3.96 ± 0.23) × 10-4mm2 / s on the sacrum side, Compared with before treatment decreased, the difference between groups was statistically significant. Semi-quantitative indicators Fenh, Senh were significantly lower than the control group, Tmax higher than the control group, the difference was statistically significant. The sacroiliac sacroiliac joint, iliac crest value and the Fenh value had a highly positive correlation (P <0.05), and the iliac ADC value had a highly positive correlation with Senh (P <0.05). [Conclusion] The DWI and DCE sequences can be used to evaluate the degree of inflammation in AS and reflect the curative effect of AS in early stage, and provide a reliable imaging basis for clinical curative effect.