Ho Yin Chung, Jin Xian Huang, Kam Ho Lee, Helen Hoi Lun Tsang, Chak Sing Lau, Shirley Chiu Wai Chan
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引用次数: 0
Abstract
Background: Magnetic resonance imaging (MRI) is important in the management of axial spondyloarthritis (SpA). However, many MRI lesions are not exclusive to axial SpA. Further characterization of these lesions may lead to better clinical decisions.
Objective: The objective of this study was to compare the frequency of individual spinal MRI lesions between axial SpA and noninflammatory back pain. The factors associated with individual lesions in participants with axial SpA were also determined.
Design: This was a cross-sectional observational study.
Methods: MRI lesions in 447 participants with axial SpA and 122 participants with noninflammatory back pain were compared using the propensity score adjustment method. Individual lesions included discovertebral lesions (DVL), Modic type 1 lesions, DVL without Modic type 1 lesions, facet joint lesions, costovertebral joint lesions, corner inflammatory lesions (CIL), and fatty corner lesions (FCL). The factors associated with the lesions were determined using regression analyses.
Results: Among participants with axial SpA, 81.9% were HLA-B27-positive, 55.0% had radiographic axial SpA, and 60.5% had radiographic features of spinal damage (mSASSS >2). Almost half (48.6% in axial SpA versus 31.1% in noninflammatory back pain) had inflammatory lesions on spinal MRI. In propensity score matching with noninflammatory back pain, axial SpA had an increased occurrence of DVL without Modic type 1 lesion (OR = 3.43, p = 0.01), costovertebral lesion (OR = 11.89, p = 0.02), number of CIL (B = 1.19, p < 0.001), and number of FCL (B = 3.33, p < 0.001). Similar associations were found in the regression models in the radiographic axial SpA subgroup: DVL without Modic type 1 lesion (OR = 2.46, p = 0.001), costovertebral lesion (OR = 3.86, p < 0.001), number of CIL (B = 1.13, p < 0.001), and FCL (B = 2.29, p < 0.01).
Conclusion: MRI lesions including DVL without Modic type 1, costovertebral joint lesions, CIL, and FCL were more specific in axial SpA.
背景:磁共振成像(MRI)在中轴性脊柱炎(SpA)的治疗中很重要。然而，许多MRI病变并不局限于轴向SpA。进一步表征这些病变可能导致更好的临床决策。目的:本研究的目的是比较轴性SpA和非炎症性背痛之间个体脊柱MRI病变的频率。与轴向SpA参与者个体病变相关的因素也被确定。设计:这是一项横断面观察性研究。方法:采用倾向评分调整法对447例轴向性SpA患者和122例非炎症性背痛患者的MRI病变进行比较。个体病变包括发现性椎体病变(DVL)、Modic 1型病变、无Modic 1型病变的DVL、小关节病变、肋椎关节病变、角炎性病变(CIL)和脂肪性角病变(FCL)。使用回归分析确定与病变相关的因素。结果:在轴向SpA的参与者中，81.9%的人hla - b27阳性，55.0%的人有轴向SpA, 60.5%的人有脊柱损伤的影像学特征(mSASSS >2)。在脊柱MRI上，几乎一半(轴向SpA患者48.6%，非炎性背痛患者31.1%)有炎性病变。在倾向得分匹配检测不到发炎的迹象背痛、轴向温泉有增加发生DVL没有Modic 1型病变(或= 3.43,p = 0.01),肋椎的病变(或= 11.89,p = 0.02), CIL数量(B = 1.19, p B = 3.33, p p = 0.001),肋椎的病变(或= 3.86,p B = 1.13, p B = 2.29, p结论:MRI病灶包括DVL没有Modic 1型,肋椎的关节病变,CIL,和整柜在轴向温泉更具体。
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