早期强直性脊柱炎骶髂关节病变的X线CT和MRI对比研究

目的：探讨强直性脊柱炎骶髂关节病变早期的影像学诊断价值。方法：收集经临床确诊的59例强直性脊柱炎早期病例,回顾分析其骶髂关节CR、CT及MRI表现。结果：X线发现42例骶髂关节可疑异常,CT发现53例表现异常,59例患者MRI表现均有异常,检出病例数对比差异显著（P﹤0.05）。X线和CT的主要表现为：局部骨质硬化、侵蚀或囊性变、关节面欠光滑和毛刺感。MRI主要表现为骨髓水肿、关节软骨破坏,增强扫描可显示滑膜、关节软骨及关节韧带呈现不同程度强化。结论：强直性脊柱炎的早期影像学诊断,X线检查最为基本,但诊断意义有限;CT对分级较为客观,且能较好地显示骨质病变情况;MRI具有明显优势,结合临床,可做出早期诊断。

Comparative Study on X-ray CT MRI of Sacroiliac Joint in Ankylosing Spondylitis

Objective： To study the imaging features of early ankylosing spondylitis（AS）.Method：59 cases of AS imaging data were analyzed and reviewed retrospectively.Result： Only 42 cases of the saemoiliae joints that suspicious singular were found in X-ray and 53 in CT and 59 MRI.It showed significant difference of diagnosis rats in the three method.The major expression of X-ray and CT were bone sclerosis parcel,cystic change of the articular subsurface bone structure,erosion and speculation.The major expression of MRI were bone marrow edema at the articular subsurface,articular-cartilage damage.In the enhanced scaning,the major Expression were bone marrow,synovial,articular-cartilage,the joint ligament showed different degrees of strengthening.Articular-cartilage（8 cases）,the joint ligament（5 cases）showed different degrees of strengthening.Conclusion： For the imaging diagnostic of early lesions in ankylosing spondylitis,CR examnination is the basic method that the value is very limited.CT ingrading lesions is more external,and can show the bone lesions more clearly.There is obvious advantage on MRI,by which AS can be early diagnosed with clinical.