Objective To observe the value of intravoxel incoherent motion(IVIM)and dynamic contrast-enhanced MRI(DCE-MRI)for assessing abnormalities of brucellosis spondylitis(BS)without conventional MRI changes.Methods Data of ...Objective To observe the value of intravoxel incoherent motion(IVIM)and dynamic contrast-enhanced MRI(DCE-MRI)for assessing abnormalities of brucellosis spondylitis(BS)without conventional MRI changes.Methods Data of 36 brucellosis patients with definite spinal lesions displayed on conventional MRI(BS 1 group),14 cases without brucellosis infection nor abnormal spinal signals on MRI(control group)and 36 brucellosis patients without definite spinal lesions on conventional MRI(BS 2 group)were retrospectively analyzed.The values of IVIM parameters,including perfusion fraction(f),pure water diffusion coefficient(D)and pseudo-diffusion coefficient(D*),also of DCE-MRI parameters,including time-intensity curve(TIC)type,volume transport constant(K trans),the rate constant(K ep)and volume fraction of extravascular extracellular space per unit tissue volume(V e)were compared among groups.Univariate and multivariate logistic regression were used to screen independent factors for discriminating BS 1 and BS 2.Receiver operating characteristic curves were drawn,and the areas under the curve(AUC)were calculated to evaluate the efficiency of the above parameters for discriminating BS 1 and BS 2.Results Among IVIM parameters,compared with control group,D*values decreased but D values increased in BS 1 group,while D*values increased in BS 2 group(all adjusted P<0.05).Compared with BS 2 group,BS 1 group had higher values of f and D and lower D*(all adjusted P<0.05).In BS 1 group,the TIC types were predominantly typeⅠ(23/36,63.89%),which were wholly or predominantly typeⅢin BS 2 group and control group,and of the former was significantly different with latter 2(both adjusted P<0.05).Compared with control group,K trans increased progressively in both BS 1 and BS 2 groups(both adjusted P<0.05).BS 1 group had lower K ep and higher V e than BS 2 and control groups(all adjusted P<0.05).Among univariate logistic regression models,the model including only f had lower capability for discriminating BS 1 and BS 2(AUC=0.759)than those including D,K trans and V e(AUC=0.951,0.833,0.894,all P<0.05).No significant different was found among multivariate logistic regression model including f and D,model including K trans and V e nor model including all above parameters(all P>0.05).Conclusion Both IVIM and DCE-MRI could be used to evaluate BS abnormality without conventional MRI changes.展开更多
目的:探讨强直性脊柱炎(ankylosing spondylitis,AS)胸腹部折叠畸形的CT影像学分型及评估方法。方法:回顾性分析2017年7月~2024年1月31例行胸腰椎CT检查的AS胸腰椎后凸畸形患者资料,男28例,女3例,平均年龄45.0±8.9岁。在胸腰椎CT...目的:探讨强直性脊柱炎(ankylosing spondylitis,AS)胸腹部折叠畸形的CT影像学分型及评估方法。方法:回顾性分析2017年7月~2024年1月31例行胸腰椎CT检查的AS胸腰椎后凸畸形患者资料,男28例,女3例,平均年龄45.0±8.9岁。在胸腰椎CT正中矢状面上测量胸腹折叠角(thoracoabdominal folded angle,TAFA)及剑突-耻骨联合距离(the distances between xiphoid process and superior edge of the pubis,XP),同时在脊柱全长侧位片上测量全脊椎后凸Cobb角(global kyphosis,GK)、胸椎后凸Cobb角(thoracic kyphosis,TK)、腰椎前凸Cobb角(lumbar lordosis,LL)及矢状面躯干偏移(sagittal vertical axis,SVA)。根据CT矢状面腰椎生理曲度对腹腔容积变化的影响创新性提出AS胸腹部折叠畸形的CT影像学分型,腰椎存在生理前凸时为Ⅰ型,腰椎生理曲度变直时为Ⅱ型,腰椎后凸畸形时为Ⅲ型。根据TAFA将Ⅲ型患者分为两个亚型,TAFA>90°为A亚型,TAFA≤90°为B亚型。由5名经过培训的脊柱外科医师先后对患者的临床资料进行独立评估与分型(间隔10d),采用Kendall′s W检验分析多组观察结果的一致性。采用单因素方差分析检验比较各型间上述测量参数的差异性。结果:31例患者中,胸腹部折叠畸形Ⅰ型5例、Ⅱ型8例、ⅢA型12例、ⅢB型6例。观察者间分型Kendall′s W一致性系数为0.954(P<0.001)。患者平均GK、TK、LL、SVA、TAFA及XP分别为83.7°±29.9°、48.7°±21.3°、-13.9°±25.3°、22.8±14.9cm、128.1°±50.5°及16.8±8.9cm;各组TAFA、XP测量数值间Kendall′s W一致性系数分别为0.946(P<0.001)和0.979(P<0.001);各分型间TAFA及XP两两比较均具有显著性差异(P<0.001)。结论:CT影像学分型可以客观评价AS胸腹部折叠畸形情况,剑突-耻骨联合距离及胸腹折叠角是评估AS胸腹部折叠畸形的重要指标。展开更多
目的利用孟德尔随机化(Mendelian randomization,MR)分析强直性脊柱炎(ankylosing spondylitis,AS)与骨质疏松(osteoporosis,OP)以及不同部位骨密度(bone mineral density,BMD)之间的因果关系。方法从IEU Open GWAS project数据平台、...目的利用孟德尔随机化(Mendelian randomization,MR)分析强直性脊柱炎(ankylosing spondylitis,AS)与骨质疏松(osteoporosis,OP)以及不同部位骨密度(bone mineral density,BMD)之间的因果关系。方法从IEU Open GWAS project数据平台、英国生物银行以及骨质疏松联盟网站等不同平台获得暴露与结局的GWAS汇总数据,借助于Two-Sample MR软件包中的逆方差加权(Inverse-variance weighting,IVW)、加权中位数法、简单模型法、MR-Egger回归以及加权模型法来分析AS与OP以及不同部位BMD间的关系,其中IVW是主要分析方法,并通过敏感性分析验证结果的可靠性。结果遗传预测AS与OP之间呈正向因果关联(OR=1.003,P=0.004),但未发现AS与全身、腰椎、股骨颈、前臂、足跟等不同部位BMD具有因果关联。异质性、多效性结果肯定了本次研究的稳健性。结论AS与OP的发生存在因果关联,可能会增加OP的发病风险。展开更多
文摘Objective To observe the value of intravoxel incoherent motion(IVIM)and dynamic contrast-enhanced MRI(DCE-MRI)for assessing abnormalities of brucellosis spondylitis(BS)without conventional MRI changes.Methods Data of 36 brucellosis patients with definite spinal lesions displayed on conventional MRI(BS 1 group),14 cases without brucellosis infection nor abnormal spinal signals on MRI(control group)and 36 brucellosis patients without definite spinal lesions on conventional MRI(BS 2 group)were retrospectively analyzed.The values of IVIM parameters,including perfusion fraction(f),pure water diffusion coefficient(D)and pseudo-diffusion coefficient(D*),also of DCE-MRI parameters,including time-intensity curve(TIC)type,volume transport constant(K trans),the rate constant(K ep)and volume fraction of extravascular extracellular space per unit tissue volume(V e)were compared among groups.Univariate and multivariate logistic regression were used to screen independent factors for discriminating BS 1 and BS 2.Receiver operating characteristic curves were drawn,and the areas under the curve(AUC)were calculated to evaluate the efficiency of the above parameters for discriminating BS 1 and BS 2.Results Among IVIM parameters,compared with control group,D*values decreased but D values increased in BS 1 group,while D*values increased in BS 2 group(all adjusted P<0.05).Compared with BS 2 group,BS 1 group had higher values of f and D and lower D*(all adjusted P<0.05).In BS 1 group,the TIC types were predominantly typeⅠ(23/36,63.89%),which were wholly or predominantly typeⅢin BS 2 group and control group,and of the former was significantly different with latter 2(both adjusted P<0.05).Compared with control group,K trans increased progressively in both BS 1 and BS 2 groups(both adjusted P<0.05).BS 1 group had lower K ep and higher V e than BS 2 and control groups(all adjusted P<0.05).Among univariate logistic regression models,the model including only f had lower capability for discriminating BS 1 and BS 2(AUC=0.759)than those including D,K trans and V e(AUC=0.951,0.833,0.894,all P<0.05).No significant different was found among multivariate logistic regression model including f and D,model including K trans and V e nor model including all above parameters(all P>0.05).Conclusion Both IVIM and DCE-MRI could be used to evaluate BS abnormality without conventional MRI changes.
文摘目的:探讨强直性脊柱炎(ankylosing spondylitis,AS)胸腹部折叠畸形的CT影像学分型及评估方法。方法:回顾性分析2017年7月~2024年1月31例行胸腰椎CT检查的AS胸腰椎后凸畸形患者资料,男28例,女3例,平均年龄45.0±8.9岁。在胸腰椎CT正中矢状面上测量胸腹折叠角(thoracoabdominal folded angle,TAFA)及剑突-耻骨联合距离(the distances between xiphoid process and superior edge of the pubis,XP),同时在脊柱全长侧位片上测量全脊椎后凸Cobb角(global kyphosis,GK)、胸椎后凸Cobb角(thoracic kyphosis,TK)、腰椎前凸Cobb角(lumbar lordosis,LL)及矢状面躯干偏移(sagittal vertical axis,SVA)。根据CT矢状面腰椎生理曲度对腹腔容积变化的影响创新性提出AS胸腹部折叠畸形的CT影像学分型,腰椎存在生理前凸时为Ⅰ型,腰椎生理曲度变直时为Ⅱ型,腰椎后凸畸形时为Ⅲ型。根据TAFA将Ⅲ型患者分为两个亚型,TAFA>90°为A亚型,TAFA≤90°为B亚型。由5名经过培训的脊柱外科医师先后对患者的临床资料进行独立评估与分型(间隔10d),采用Kendall′s W检验分析多组观察结果的一致性。采用单因素方差分析检验比较各型间上述测量参数的差异性。结果:31例患者中,胸腹部折叠畸形Ⅰ型5例、Ⅱ型8例、ⅢA型12例、ⅢB型6例。观察者间分型Kendall′s W一致性系数为0.954(P<0.001)。患者平均GK、TK、LL、SVA、TAFA及XP分别为83.7°±29.9°、48.7°±21.3°、-13.9°±25.3°、22.8±14.9cm、128.1°±50.5°及16.8±8.9cm;各组TAFA、XP测量数值间Kendall′s W一致性系数分别为0.946(P<0.001)和0.979(P<0.001);各分型间TAFA及XP两两比较均具有显著性差异(P<0.001)。结论:CT影像学分型可以客观评价AS胸腹部折叠畸形情况,剑突-耻骨联合距离及胸腹折叠角是评估AS胸腹部折叠畸形的重要指标。
文摘目的探索利用动态对比增强MRI(dynamic contrast-enhanced MRI,DCE-MRI)多参数及影像组学数据,构建中轴型脊柱关节炎炎症活动性评估模型,为临床诊治提供参考。材料与方法纳入93例经临床诊断的中轴型脊柱关节炎患者,依据强直性脊柱炎疾病活动评价积分(ankylosing spondylitis disease activity score,ASDAS)分为炎症活动性组和非炎症活动性组。所有患者均行骶髂关节DCE-MRI扫描。利用Omni-Kinetics后处理软件测量骶髂关节感兴趣区域定量渗透参数、定量灌注参数和半定量参数。使用ITK-SNAP软件勾画双侧骶骨、髂骨面的感兴趣体积(volume of interest,VOI),利用Artificial Intelligent Kit(A.K.)软件提取影像组学特征,然后通过交叉验证、LASSO等方法构建了不同中轴型脊柱关节炎炎症活动性的预测模型,包括加拿大脊柱炎研究联盟(Spondyloarthritis Research Consortium of Canada,SPARCC)评分模型、DCE-MRI多参数联合模型、DCE-MRI影像组学综合模型,通过受试者工作特征(receiver operating characteristic,ROC)曲线分析进行验证,并通过曲线下面积(area under the curve,AUC)、准确率、敏感度、特异度判别模型效能。结果(1)SPARCC的AUC(95%CI)为0.697(0.589~0.805);(2)反流速率常数(efflux rate constant,K_(ep))、达峰时间(time to peak,TTP)、血管外细胞外容积分数(extravascular extracellular volume fraction,V_(e))参数t检验或U检验P值<0.05,AUC(95%CI)分别为0.628(0.505~0.751)、0.648(0.535~0.761)、0.630(0.511~0.749),DCE-MRI多参数联合模型的AUC为0.712(0.600~0.823);(3)DCE-MRI影像组学的AUC(95%CI)为0.617(0.489~0.746)至0.889(0.826~0.953),DCE-MRI影像组学综合模型的AUC(95%CI)为0.951(0.910~0.992);(4)DCE-MRI影像组学综合模型的诊断效能优于DCE-MRI多参数联合模型及SPARCC评分模型(AUC:0.951 vs.0.712,0.951 vs.0.697;P均<0.001)。结论DCE-MRI影像组学综合模型在中轴型脊柱关节炎炎症活动性评估中优于DCE-MRI参数联合模型及SPARCC评分模型,为中轴型脊柱关节炎临床诊治提供了新的参考依据。
文摘目的利用孟德尔随机化(Mendelian randomization,MR)分析强直性脊柱炎(ankylosing spondylitis,AS)与骨质疏松(osteoporosis,OP)以及不同部位骨密度(bone mineral density,BMD)之间的因果关系。方法从IEU Open GWAS project数据平台、英国生物银行以及骨质疏松联盟网站等不同平台获得暴露与结局的GWAS汇总数据,借助于Two-Sample MR软件包中的逆方差加权(Inverse-variance weighting,IVW)、加权中位数法、简单模型法、MR-Egger回归以及加权模型法来分析AS与OP以及不同部位BMD间的关系,其中IVW是主要分析方法,并通过敏感性分析验证结果的可靠性。结果遗传预测AS与OP之间呈正向因果关联(OR=1.003,P=0.004),但未发现AS与全身、腰椎、股骨颈、前臂、足跟等不同部位BMD具有因果关联。异质性、多效性结果肯定了本次研究的稳健性。结论AS与OP的发生存在因果关联,可能会增加OP的发病风险。
