摘要
目的 探讨动态增强磁共振成像(DCE-MRI)定量参数对类风湿性关节炎的诊断价值及与凝血功能状态的关系.方法 选取我院类风湿性关节炎患者 80 例为观察组,另选取排除类风湿性关节炎诊断的正常关节受检者 60 例为对照组.比较两组DCE-MRI定量参数[相对增强(RE)、曲线下面积(AUC)、最大相对增强(MRE)、最大强化斜率(Slope-max)、最大增强(ME)],评价DCE-MRI定量参数对类风湿性关节炎的诊断价值,比较不同预后患者临床资料、DCE-MRI定量参数及凝血功能指标[D-二聚体(D-D)、纤维蛋白原(FBG)、凝血酶原时间(PT)、部分凝血酶原时间(APTT)],分析DCE-MRI定量参数及凝血功能指标与临床资料的相关性,DCE-MRI定量参数及凝血功能指标与类风湿性关节炎患者预后的关系,DCE-MRI定量参数与凝血功能指标相关性.结果 观察组RE、MRE、ME、Slopemax、AUC均高于对照组,差异有统计学意义(P<0.05);RE、MRE、ME、Slopemax、AUC诊断类风湿性关节炎的AUC值分别为 0.719、0.767、0.800、0.834、0.814,联合预测AUC值最大为 0.928;预后不良患者病程、关节压痛与肿胀指数、疾病活动度、RE、MRE、ME、Slopemax、AUC、FBG、D-D、PT、APTT与预后良好患者比较,差异有统计学意义(P<0.05);RE、MRE、ME、Slopemax、AUC、FBG、D-D、PT、APTT均与类风湿性关节炎患者病程,关节压痛指数,关节肿胀指数,疾病活动度及预后情况显著相关(P<0.05);RE、MRE、ME、Slopemax、AUC均与类风湿性关节炎患者FBG、D-D、PT、APTT呈正相关关系(P<0.05).结论 DCE-MRI定量参数与类风湿性关节炎凝血功能状态有关,可作为临床诊断类风湿性关节炎诊断、病情评估及预后预测的可靠手段,为临床提供参考依据.
Abstract
Objective To explore the diagnostic value of quantitative parameters of dynamic contrast-enhanced MRI(DCE-MRI)in rheumatoid arthritis and its relationship with coagulation function status.Methods 80 patients with rheumatoid arthri-tis in our hospital were selected as the observation group,and 60 normal joint subjects who were excluded from the diagnosis of rheumatoid arthritis were selected as the control group.The quantitative parameters of DCE-MRI[relative enhancement(RE),area under the curve(AUC),maximum relative enhancement(MRE),slope of maximum enhancement(Slopemax),maximum enhancement(ME)]were compared between the two groups,and the quantitative parameters of DCE-MRI were evaluated.The diagnostic value of rheumatoid arthritis,the clinical data,DCE-MRI quantitative parameters and coagulation function indexes[D-dimer(D-D),fibrinogen(FBG),prothrombin time(PT),Partial prothrombin time(APTT)]were assessed,the correlation of DCE-MRI quantitative parameters and coagulation function indexes with clinical data,the relationship between DCE-MRI quantitative parameters and coagulation function indexes and prognosis of patients with rheumatoid arthritis,DCE-MRI Quantita-tive parameters were correlated with coagulation function indexes.Results The RE,MRE,ME,Slopemax and AUC of the ob-servation group were higher than those of the control group,and the difference was statistically significant(P<0.05);The AUC values of RE,MRE,ME,Slopemax,and AUC for diagnosing rheumatoid arthritis were 0.719,0.767,0.800,0.834,and 0.814,respectively,and the combined predicted AUC value was 0.928.There were significant differences in disease activity,RE,MRE,ME,Slopemax,AUC,FBG,D-D,PT,APTT and patients with good prognosis(P<0.05);RE,MRE,ME,Slopemax,AUC,FBG,D-D,PT,APTT were significantly correlated with the course of disease,joint tenderness index,joint swelling in-dex,disease activity and prognosis in patients with rheumatoid arthritis(P<0.05);RE,MRE,ME,Slopemax,AUC were posi-tively correlated with FBG,D-D,PT,APTT in patients with rheumatoid arthritis(P<0.05).Conclusion The quantitative pa-rameters of DCE-MRI are related to the coagulation function status of rheumatoid arthritis,which can be used as a reliable method for clinical diagnosis,condition assessment and prognosis prediction of rheumatoid arthritis,and provide a reference for clinical practice.
维普
万方数据