实用医学杂志 ›› 2023, Vol. 39 ›› Issue (8): 1035-1039.doi: 10.3969/j.issn.1006⁃5725.2023.08.020

• 医学检查与临床诊断 • 上一篇    下一篇

视神经脊髓炎的常规MRI 及DTI 的量化诊断研究 

韩栋 孙媛 刘春杰 李明玉 赛金海 王胜林    

  1. 承德医学院附属医院放射科(河北承德067000)
  • 出版日期:2023-04-25 发布日期:2023-04-25
  • 通讯作者: 王胜林 E⁃mail:shl_w2005@163.com
  • 基金资助:
    承德市科技计划项目(编号:202204A067)

A quantitative diagnosis of conventional MRI and DTI in neuromyelitis optica

HAN Dong,SUN Yuan, LIU Chunjie,LI Mingyu,SAI Jinhai,WANG Shenglin.   

  1. Department of Radiology,the Affiliated Hospital of Chengde Medical University,Chengde 067000,China 

  • Online:2023-04-25 Published:2023-04-25
  • Contact: WANG Shenglin E⁃mail:shl_w2005@163.com

摘要:

目的 以健康脊髓为对照,探讨常规核磁共振(MRI)及扩散张量成像(DTI)的量化诊断视神 经脊髓炎(NMO)的价值。方法 选取 2020 年 9 月至 2022 年 3 月 20 例 NMO 患者(NMO 组)及 20 例健康人 群(对照组),均行常规 MRI 及 DTI 检查,统计两组常规 MRI 表现、平均扩散系数(ADC)、部分各向异性 (FA)、平均弥散率(MD),采用受试者工作特征曲线(ROC)分析常规 MRI、DTI 定量参数诊断价值,筛选出 诊断敏感度与特异度最高的参数,将其与血清学 NMO⁃IgG 联合,分析其诊断 NMO 的价值。结果 NMO 组 ADC、MD 高于对照组,FA 值低于对照组(P < 0.05);常规 MRI 诊断 NMO 特异度 100.00%最高,ADC 诊断 NMO 敏感度 90.00%最高,且 AUC 0.811 最大,二者联合诊断 AUC 0.918 进一步增大;血清 NMO⁃IgG 阳性+常 规 MRI+ADC 诊断的 AUC 为 0.955,敏感度为 90.00%,特异度为 95.00%。结论 常规 MRI 及 DTI 定量参数 可用于 NMO 早期诊断中,临床可通过联合血清 NMO⁃IgG 进行早期辅助诊断,以提高诊断效能,为针对性 制定个体化治疗方案提供可靠依据。

关键词: 视神经脊髓炎, 核磁共振, 扩散张量成像, 诊断

Abstract:

Objective To investigate the value of conventional magnetic resonance imaging(MRI)and diffusion tensor imaging(DTI)in the quantitative diagnosis of neuromyelitis optica(NMO)with normal spinal cord as control. Methods 20 NMO patients(NMO group)and 20 healthy people(control group)from September 2020 to March 2022 were selected,and they all underwent routine MRI and DTI examinations. The routine MRI performance,average diffusion coefficient(ADC),partial anisotropy(FA),and average diffusion rate(MD) were calculated in both groups;the receiver operating characteristic(ROC)and area under ROC(Area under ROC)were used to analyze the diagnostic value of conventional MRI and DTI quantitative parameters. The parame⁃ ters of the highest diagnostic sensitivity and specificity were screened out and they were combined with serological NMO⁃IgG to analyze their diagnostic value for NMO. Results The ADC and MD were higher in the NMO group than in the control group,while the FA value was lower(P < 0.05);Conventional MRI had the highest specificity of 100.00% for the diagnosis of NMO,ADC had the highest sensitivity of 90.00% for the diagnosis of NMO,and the AUC of 0.811 was the highest. The combined diagnosis of both methods further increased the AUC of 0.918; the AUC of positive serum NMO ⁃ IgG plus conventional MRI and ADC was 0.955,with the sensitivity of 90.00% and the specificity of 95.00%. Conclusion Conventional MRI and DTI quantitative parameters can be used in the early diagnosis of NMO. The clinical combination of serum NMO⁃IgG can be applied for early auxiliary diagnosis to improve the diagnostic efficiency and it provides a reliable basis for the development of individualized therapies.

Key words: neuromyelitis optica, nuclear magnetic resonance, diffusion tensor imaging, diagnosis