强直性脊柱炎脊柱Andersson损害的磁共振成像特点

目的 探讨强直性脊柱炎(ankylosing spondylitis,AS) 脊柱Andersson损害(Andersson lesions,AL) 的磁共振成像(magnetic resonance imaging, MRI)特征。方法 回顾性分析2018年7月-2021年11月在哈尔滨工业大学医院放射科、2018年1月-2021年11月在哈尔滨医科大学附属第二医院MRI诊断科进行脊柱MRI检查的AS患者78例,依据MRI表现,将出现AL的AS患者分为炎症型组(n=23)和创伤型组(n=10),并比较两组临床资料。结果 78例AS患者中出现AL 33例,检出率为42.3%。创伤型组改良Stoke强直性脊柱炎脊柱评分(modified Stoke ankylosing spondylitis spine score, mSASSS)高于炎症型组(P<0.05)。两组受累椎体-椎间盘单元(discovertebral units,DVUs)差异有统计学意义(P<0.05),MRI影像学特点不同。相关分析显示,红细胞沉降率(erythrocyte sedimentation rate, ESR)、C反应蛋白(C-reactive protein,CRP)、人类白细胞抗原-B27(human leukocyte antigen-B27,HLA-B27)、Bath强直性脊柱炎病情活动指数(Bath ankylosing spondylitis disease activity index, BASDAI)、mSASSS与受累DVUs数量均无相关性(P>0.05)。结论 AL在AS患者中并不罕见,炎症型AL与创伤型AL有不同的MRI表现,MRI在检测和评价AL中具有重要价值。

Magnetic resonance imaging characteristics of Andersson lesions associated with ankylosing spondylitis

Objective To investigate the magnetic resonance imaging (MRI) characteristics of Anderson lesions (AL) associated with ankylosing spondylitis (AS). Methods A retrospective analysis was made on 78 AS patients who underwent spinal MRI examination in the Department of Radiology, Harbin Institute of Technology Hospital from July 2018 to November 2021, and in the Department of MRI, the 2nd Affiliated Hospital of Harbin Medical University from January 2018 to November 2021.The clinical data were compared in two groups which comprised 23 (inflammatory group) and 10 (traumatic group) patients. Results Among 78 AS patients, 33 had AL, with a detection rate of 42.3%. The modified Stoke ankylosing spondylitis spine score (mSASSS) in traumatic group was higher than that in inflammatory group (P<0.05). The difference of involved discovertebral units (DVUs) between the two groups was statistically significant (P<0.05), and the MRI characteristics were different. Correlation analysis showed that erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), human leucocyte antigen-B27 (HLA-B27), Bath ankylosing spondylitis disease activity index (BASDAI), mSASSS were not correlated with the number of involved DVUs(P>0.05). Conclusion AL is not rare in AS patients. Inflammatory AL and traumatic AL have different MRI manifestations. MRI has important value in detecting and evaluating AL.