基于DCE-MRI图像TIC分析法的类风湿关节滑膜炎定量评估-《中国医学物理学杂志》

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Title:: Quantitative evaluation of rheumatoid synovitis with TIC analysis of DCE-MRI image

文章编号:: 1005-202X（2024）04-0426-07

作者:: 毛瑾玲1; 朱中旗1; 李英豪1; 何东仪2; 姜婷2; 夏天1; 石洁2; 汪红志1; 1.华东师范大学物理与电子科学学院/上海市磁共振重点实验室，上海 200062； 2.上海市光华中西医结合医院医学影像科，上海 200523

Author(s):: MAO Jinling1; ZHU Zhongqi1; LI Yinghao1; HE Dongyi2; JIANG Ting2; XIA Tian1; SHI Jie2; WANG Hongzhi1; 1. Shanghai Key Laboratory of Magnetic Resonance/School of Physics and Electronic Science, East China Normal University, Shanghai 200062, China 2. Department of Medical Imaging, Shanghai Guanghua Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai 200523, China

关键词:: 滑膜炎; 血管翳; 腕关节; 磁共振成像; TIC分析

Keywords:: Keywords: synovitis pannus wrist joint magnetic resonance imaging time-intensity curve analysis

分类号:: R312；O482.53

DOI:: DOI:10.3969/j.issn.1005-202X.2024.04.005

文献标志码:: A

摘要:: 目的：为了提高对评估类风湿性关节炎（RA）的诊断敏感性，对滑膜血管翳尤其是炎性血管翳的形状及数量进行量化评估和可视化呈现，为临床指导用药提供可靠依据。方法：对18例经临床病理确诊的RA患者行手腕关节DCE-MRI检查，统一对第4个时相的增强图像进行感兴趣区域（ROI）勾画。采用Spearman相关性分析评价该病例的时间强度曲线（TIC）参数［早期增强率（MSI）、强化幅值差（MSD）、达峰时间、拟合曲线尾部切线斜率］之间的相关性并确定其独立特征。使用独立特征定义4型曲线（Ⅰ型，缓升型；Ⅱ型，速升速降型；Ⅲ型，速升平台型；Ⅳ型，速升缓升型），并计算出ROI内每个类型TIC所占容积，再与RAMRIS评分结果进行比较确定相关性最强的TIC，基于该曲线特征进行滑膜炎的定量分级和二维多切片彩色编码显示。结果：MSI与MSD存在显著的正相关，Ⅱ型区域容积与RAMRIS评分具有极好的相关性（r=0.812），即动态增强MRI图像中，TIC为速升速降型区域符合滑膜炎性血管翳类型。结论：TIC分析法方便医生精准地进行炎性血管翳的定量分析，为RA患者疾病严重程度的诊断及用药治疗前后对比提供重要临床信息。

Abstract:: Abstract: Objective To improve the diagnostic sensitivity to rheumatoid arthritis (RA) by quantitatively evaluating and visualizing the shape and quantity of synovial pannus, especially inflammatory pannus, thereby providing reliable evidence for clinical medication guidance. Methods The wrists of 18 patients with RA confirmed by clinicopathology were examined with dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI), and the region of interest was delineated for the 4th phase of the enhanced image. Spearman correlation analysis was used to evaluate the correlations of time-intensity curves (TIC) parameters, including early enhancement rate (MSI), enhancement amplitude difference (MSD), time to peak, tangent slope of fitted curve tail, and determine the independent feature which was then used to define the type of curves (type Ⅰ, slow enhancement type Ⅱ, fast enhancement followed by washout phase type Ⅲ, fast enhancement followed by plateau phase type Ⅳ, fast enhancement followed by slow enhancement increase). The volume of each type of TIC in ROI was calculated, and then compared with RAMRIS score for determining the TIC with the strongest correlation. Based on the characteristics of the selected curve, the quantitative classification of synovitis and two-dimensional multi-section color coding were carried out. Results MSI had significant positive correlation with MSD, and the volume of type Ⅱ TIC was correlated with RAMRIS score (r=0.812), indicating that in DCE-MRI image, the volume of type Ⅱ TIC was consistent with the type of synovitis pannus. Conclusion Statistical analysis of TIC is convenient for doctors to accurately and quantitatively analyze inflammatory pannus, providing important clinical information for diagnosis of disease severity and comparison before and after drug treatment in patients with RA.

《中国医学物理学杂志》[ISSN:1005-202X/CN:44-1351/R]

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