| Objective:Two models of incoherent motion diffusion weighted imaging(IVIM-DWI)and diffusion kurtosis imaging((DKI))were used to study the value of their parameters in the diagnosis of(AS)active sacroiliitis(SIS)in ankylosing spondylitis,and whether the diagnostic efficiency was improved by comparing with conventional DWI.Methods:The clinical data of patients with chronic low back pain admitted to the rheumatic immunology department of our hospital from December 2019 to March 2021 were collected,and the diagnosis and treatment guidelines of AS were used to determine whether the patient was AS,43 AS patients who met the diagnostic criteria were divided into active group(n=23)and stable group(n=20).The MRI images of the two groups were analyzed and compared,and the relevant quantitative parameters of IVIM-DWI and DKI model and pseudo-color maps of each parameter were obtained by outlining the region of interest,including(D,D~*,f,MD and MK values).These parameters which are different and statistically significant are analyzed by Logistics regression model,and the ROC curve is drawn to compare the diagnostic efficiency of each parameter value.Results:1.In the IVIM sequence,the active group D value=0.72±0.28,f value=0.32±0.56,the stable group D value=0.37±0.19,f value=0.28±0.52;the independent sample t test was performed using SPSS software,and the D values of the two groups were compared with There is a difference in the f value(p<0.05);the D*value of the active group=9.30±1.58,and the stable group=8.65±0.78.After testing,there is no statistical difference in D*between the two(p>0.05).2.In the DKI sequence,the MD value of the active group was 1.11±0.37,the MK value was1.36±0.32,the MD of the stable group was 0.71±0.18,and the MK value was 1.92±0.28.There were statistical differences between the two parameters(p<0.05).3.In the routine DWI sequence,the ADC value in the active phase=0.86±0.29,and the ADC value in the stable phase=0.47±0.18.After testing,there are statistical differences between the two groups(p<0.05).4.In terms of diagnostic activity,the area under the ROC curve of the five parameters D,f,MD,MK,and ADC values of the active group were 0.832,0.723,0.807,0.895,and 0.847,respectively;this study also used the 5 parameters of IVIM,DKI and conventional DWI Combine two meaningful parameters(D,f,MD,MK,and ADC values)to get D+f,MD+MK,D+f+MD+MK,ADC+MK values and the combined ROC area are 0.875 and0.893,espectively,0.937,0.911.Conclusion:IVIM-DWI and DKI models are useful in the diagnosis of SIS activity in the identification of AS,and can quantify the lesions,and the MK value is the parameter with the highest diagnostic efficiency.By combining several meaningful parameters(D,f,MD,MK and ADC values)of IVIM,DKI and conventional DWI,the result is a combined diagnosis of four parameters(D+f+MD+MK)of IVIM and DKI models The highest value.In this study,the combined diagnostic parameters(D+f,MD+MK,D+f+MD+MK,ADC+MK)were compared with the conventional ADC by ROC analysis,and it was concluded that the combination of parameters could not significantly improve its diagnostic value. |
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