Value of magnetic resonance imaging features in the assessment of disease activity and their relationship with TCM syndrome types in patients with ankylosing spondylitis

XU Meng; WANG Guangping; BAI Hongjun; WANG Bing; HE Pinggen; LIU Dan

doi:10.3969/j.issn.1002-3429.2026.05.014

Abstract：Objective To investigate the value of magnetic resonance imaging(MRI)features in assessing the disease activity in patients with ankylosing spondylitis(AS)and their relationship with traditional Chinese medicine(TCM)syndrome types.Methods From October 2018 to April 2021,102 patients with AS who were admitted to the hospital were selected as the study group,and 100 healthy volunteers who underwent physical examinations during the same period were selected as the control group.The study group was subdivided into the active subgroup(n=54)and the stable subgroup(n=48)based on the Bath Ankylosing Spondylitis Disease Activity Index(BASDAI)score.All the subjects underwent MRI examinations,and their MRI manifestations and Spondyloarthritis Research Consortium of Canada(SPARCC)score were observed.In the meantime,the clinical data,MRI features and imaging grading of patients with different TCM syndrome types(liver and kidney deficiency syndrome,damp-heat syndrome,and governor vessel cold syndrome)were compared.Results Among the 102 enrolled patients,52 patients developed bone marrow edema,presenting as hyperintensity on apparent diffusion coefficient maps,hypointensity on T1-weighted imaging,and hyperintensity on proton density-weighted imaging.The main MRI manifestations of the sacroiliac joints in patients with AS included bone marrow edema,bone destruction,erosion,and fat deposition.The SPARCC scores of the active subgroup and the stable subgroup[(22.35±5.43),(16.57±4.34)points]were higher than that of the control group(3.25±1.22 points),which were higher in the active subgroup than in the stable subgroup(P<0.05).The BASDAI and SPARCC scores of patients with damp-heat syndrome and governor vessel cold syndrome in patients with AS were higher than those of patients with liver-kidney deficiency syndrome(P<0.05).The incidence of bone cystic changes on the joint surface and the imaging grade of AS patients with damp-heat syndrome were higher than those of patients with governor vessel cold syndrome and liver-kidney deficiency syndrome(P<0.05).Conclusion The MRI features can reflect the disease activity of patients with AS and have a certain correlation with the TCM syndrome types.This suggests that the MRI features can provide an objective basis for the TCM syndrome differentiation of AS.