强直性脊柱炎患者脊柱MRI的炎症病变与骨 [复制链接]

目的：确定强直性脊柱炎（AS）患者脊髓磁共振成像（MRI）炎症性病变和骨小梁评分（TBS）之间的关系。

方法：97例AS患者接受脊柱MRI和腰椎双能X线骨密度仪测量TBS和骨密度。MRI上的骨髓水肿（BME）被认为是炎性病变。MRI上，对第1至第4腰椎深度（1cm）的BME和信号强度进行评分。记录MRI检查时的炎症标志物和脊柱结构损伤评分。评估MRI炎症活动评分和TBS之间的关系。

结果：在97名患者中，52名患者在脊柱MRI（L1-L4）上进行BME检查。有和没有BME的患者的平均TBS值分别为1.38±0.11和1.43±0.11（P=0.）。脊髓MRI的总炎症活动评分与TBS呈负相关，但与骨矿物质密度无关。具有高骨折风险的TBS值的患者在MRI上具有更深的BME（1cm）（P=0.）。在校正年龄，症状持续时间和腰椎结构损伤后，TBS随着MRI炎症严重程度的增加而降低（P=0.）。

讨论：在AS患者中，脊髓MRI上的炎症与TBS呈负相关。脊柱局部骨炎的严重程度与骨质量减低相关。这些研究结果表明，控制活动性骨炎可能有效预防AS患者的骨质疏松症。

附原文：

OBJECTIVEodeterminetheassociationbetweeninflammatorylesionsonspinalmagneticresonanceimaging(MRI)andtrabecularbonescore(TBS)inpatientswithankylosingspondylitis(AS).

METHODS:Ninety-sevenpatientswithASunderwentspineMRIanddualenergyx-rayabsorptiometryofthelumbarspinetomeasureTBSandbonemineraldensity.Bonemarrowedema(BME)onMRIwasconsideredaninflammatorylesion.Thepresence,depth(1?cm),andintensityofBMEonMRIwerescoredforthe1st-4thlumbarspinesegments.InflammatorymarkersandspinalstructuraldamagescoresatthetimeofMRIexaminationwererecorded.TheassociationbetweeninflammatoryactivityscoreonMRIandTBSwasevaluated.

RESULTS:Amongthe97patients,52hadBMEonspinalMRI(L1-L4).ThemeanTBSvalueswere1.38±0.11and1.43±0.11forpatientswithandwithoutBME,respectively(p?=?0.).TotalinflammatoryactivityscoresonspinalMRIcorrelatednegativelywithTBS,butnotwithbonemineraldensity.PatientswithaTBSvaluerepresentingahighfractureriskhadmoredeepBME(1?cm)(p?=?0.)onMRI.Afteradjustmentforage,symptomduration,andlumbarspinalstructuraldamage,theTBSdecreasedasinflammationseverityonMRIincreased(p?=?0.).

DISCUSSION:InASpatients,inflammationonspinalMRIwasnegativelycorrelatedwithTBS.Theseverityoflocalboneinflammationinthespinewasassociatedwithpoorbonequality.ThesefindingssuggestthatthecontrolofactiveboneinflammationmaybeeffectiveforpreventingosteoporosisinASpatients.

KEYWORDS:Ankylosingspondylitis;MRI;bonemarrowedema;dualenergyx-rayabsorptiometry;trabecularbonescore

引自：JungJY1,HanSH1,HongYS2,3,etal.Inflammationonspinalmagneticresonanceimagingisassociatedwithpoorbonequalityinpatientswithankylosingspondylitis.ModRheumatol.Aug10:1-20.doi:10./...[Epubaheadofprint]

来源：中国风湿病公众论坛

作者：JungJY

翻译：北医三院刘蕊

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