CT改良检查方法对强直性脊椎炎骶髂关节病变的诊断价值探讨

目的探讨CT改良检查方法对骶髂关节强直性脊椎炎的诊断价值。方法对22例临床及平片拟诊强直性脊椎炎患者骶髂关节常规方法与改良方法检查结果对照分析。结果本组22例44个关节,常规法诊断为正常或不能明确的3例,诊断为早期病变的有9例15个关节,诊断为进展期8例16个关节,稳定期2例4个关节。改良法诊断为早期病变的有12例23个关节,诊断为进展期8例16个关节,稳定期2例4个关节。结论骶髂关节CT的改良检查方法由于采用较薄的层厚扫描,减少了部分容积效应的干扰,对早期病变显示较常规法更清晰。沿骶髂关节长轴扫描,可更大范围观察病变对关节面的侵蚀破坏。进展期和稳定期骨质破坏和关节间隙的改变已比较明确,常规法和改良法的区别意义不大。

Improved CT imaging in diagnosis of ankylosing spondylitis

Objective To evaluate the improved CT imaging of sacroiliac joint in diagnosis of ankylosing spondylitis (AS).Methods 22 patients, diagnosed as AS by clinical and radiography, undertook both conventional and improved CT imaging. All images were comparatively studied.Results With conventional CT imaging, in the 44 joints of 22 cases, unremarkable images were obtained in 3 cases; early stage AS was found in 15 joints of 9 cases; AS in progressive stage was revealed in 8 cases /16 joints, stabled AS was presented in 2 cases/4 joints. There were 23 joints in 12 cases diagnosed as early term by improved imaging, progressive staged AS was shown in 8 cases/16 joints as, stable AS was demonstrated in 2 cases/4 joints.Conclusion The improved imaging is sensitive in the diagnosis of early staged AS, for the application of thin slice scan, which helps to reduce partial volume effect. Scanning along the longitudinal axis of the sacroiliac joint extends the observation of erosion of the joint surface. For progressive or stable staged AS, the alterations of bone and joint space are prominent, improved CT imaging is not superior to the conventional.