幼年强直性脊柱炎骶髂关节的CT表现

目的 总结强直性脊柱炎患儿的骶髂关节的CT影像特征。材料与方法 搜集78例强直性脊柱炎患儿,行骶髂关节CT检查。年龄6～14岁。结果 骶髂关节间隙的CT表现为正常、增宽及宽窄不均,未见变窄及强直征象。骶髂关节面的改变主要为：髂骨面的改变包括关节面的模糊、不规则,骨皮质的不连续、变薄、增厚;关节面下囊变,骨破坏,骨质缺失和骨硬化。骶骨面的改变明显较髂骨面少。左侧关节改变较右侧重且发病率高。按照国际标准分级,本组病例为0～Ⅲ级。结论 影像学特点最初表现为周围关节炎征象,而无典型中轴关节受累征象。骶髂关节炎是幼年强直性脊柱炎确诊的重要标志。     

强直性脊柱炎骶髂关节病变的CT表现

目的：通过对40例强直性脊柱炎（AS）骶髂关节CT扫描，以提高其鉴别诊断水平。方法：分析40例AS患者的骶髂关节CT表现特点。结果：骶髂关节早期CT表现为关节间隙正常，骨性关节面侵蚀破坏，基本呈对称性，关节面骨皮质毛糙不整，局限性微小皮质破坏或局限性硬化：进展期为双侧骶髂关节面广泛骨皮质破坏，呈锯齿状或毛刷状，局部骨质硬化明显，关节间隙不规则变窄或增宽：晚期为关节骨性强直和普遍性骨质疏松。骶髂关节韧带部也可发生骨侵蚀和囊变；结论：AS骶髂关节的CT表现特点，有助于临床的早期诊断，提高诊断准确率。     

强直性脊柱炎骶髂关节病变早期的CT特征研究

目的：研究强直性脊柱炎（AS）骶髂关节病变早期的CT特征。方法：对23例AS患骶髂关节病变的CT征象进行了分析。结果：23例AS患中，骶髂关节双侧受累18例，单侧受累5例；14例为早期病变的CT表现，其中4例为可疑病变，10例CT表现为骨皮质限局性硬化， 关节面模糊不清或斑点状脱钙，软骨下微小囊变，这些表现多见于骶髂关节中下部髂骨面，关节间隙基本保持正常或略增宽。结论：CT能清晰地显示早期AS骶髂关节病变并作出早期诊断。     

强直性脊柱炎临床及其骶髂关节影像学研究

综述了强直性脊柱炎及幼年强直性脊柱炎的临床表现,并比较了二者的主要不同点,以及幼年强直性脊柱炎的诊断标准.介绍了正常骶髂关节的解剖及影像解剖学,并综述了强直性脊柱炎骶髂关节的X线、CT及MRI表现.同时对强直性脊柱炎的X线及CT分级、骶髂关节炎的MRI分级做了简单介绍.     

强直性脊柱炎临床及其骶髂关节影像学研究

综述了强直性脊柱炎及幼年强直性脊柱炎的临床表现 ,并比较了二者的主要不同点 ,以及幼年强直性脊柱炎的诊断标准。介绍了正常骶髂关节的解剖及影像解剖学 ,并综述了强直性脊柱炎骶髂关节的X线、CT及MRI表现。同时对强直性脊柱炎的X线及CT分级、骶髂关节炎的MRI分级做了简单介绍     

强直性脊柱炎致骶髂关节炎的X线与CT诊断

目的 评估X线对强直性脊柱炎患者骶髂关节炎的诊断价值。方法 对临床表现为缓慢加重的腰骶部及双髋部疼痛、压痛及活动受限者68例，进行脊柱正侧位或加摄斜位X线片。其中，6例临床怀疑骶髂并节病变者又经CT检查。结果 单侧骶髂关节改变为28例，双侧骶髂关节改变40例。怀疑骶髂关节病变6例，轻度骶髂关节炎34例，中度骶髂关节炎20例，重度骶髂关节炎8例。68例中59例HLA—B27抗原阳性。结论 X线正位加左、右斜位平片能对大部分骶髂关节炎作出诊断，尤其是左、右斜位更有利于观察骶髂关节病变。对于骶髂关节炎的早期诊断，CT优于X线平片。     

强直性脊柱炎骶髂关节病变的CT诊断

目的：探讨CT对强直性脊柱炎（AS）患骶髂关节病变的早期诊断价值。方法：收集33例AS患的临床及CT资料进行分析。 参考相关献将骶髂关节病变分为：0、Ⅰ、Ⅱ、Ⅲ级。结果：33例AS患的64个骶髂关节受累，其中双侧受累31例，单侧2例。2个骶髂关节表现正常为0级；19个关节表现为轻度受侵破坏，关节面模糊，骨质疏松定为I级；22个关节表现为明显破坏，关节面呈锯齿状或串珠状参差不齐或皮质中断，关节面下可见囊状吸收区，周围骨硬化，关节间隙假性增宽定为Ⅱ级；23个关节表现为关节强直，关节间隙变窄，可见骨小梁通过关节，严重关节呈骨性融合定为Ⅲ级.结论：根据骶髂关节的CT表现，结合临床资料，可准确诊断早期AS。     

多层螺旋CT在强直性脊柱炎骶髂关节病变中的应用价值

目的:探讨多层螺旋CT在强直性脊柱炎(AS)骶髂关节病变的应用价值。方法:56例临床确诊为强直性脊柱炎患者行骶髂关节多层螺旋CT检查,观察骶髂关节病变的CT表现及影像学特征。结果:强直性脊柱炎骶髂关节病变的多层螺旋CT表现特征为病变主要累及骶髂关节的髂骨侧,表现为关节软骨钙化、关节面毛糙、骨性关节面下多发小囊状骨质吸收、破坏伴不同程度骨质增生硬化,骶髂关节间隙狭窄、消失、关节骨性融合及骶髂韧带钙化等。结论:多层螺旋CT对强直性脊柱炎(AS)骶髂关节病变的诊断与鉴别诊断具有重要的应用价值。     

18F-Fluoride PET/CT for detection of sacroiliitis in ankylosing spondylitis

Purpose  

The aim of this study was to evaluate the performance of ¹⁸F-fluoride-PET/CT (PET/CT) for the diagnosis of sacroiliac joint (SIJ) arthritis in patients with active ankylosing spondylitis (AS).     

头皮软组织病变的影像学表现

目的 探讨头皮软组织病变的CT和MRI表现,提高对此类疾病的认识.方法 收集经手术病理证实的31例头皮软组织病变,其中CT检查17例,MRI检查14例.观察头皮软组织病变的部位、大小、病变边缘情况、密度或信号特征、强化幅度、有无颅骨或脑内侵犯.结果 发病部位:枕部11例,顶部8例;形态:梭形20例,扁平形(5例);大小平均1.6cm×3.8cm;病变9例呈囊状表现,22例呈软组织密度或信号;3例无强化,10例有强化;2例侵犯临近颅骨,其中1例同时侵犯小脑.结论 影像学能显示头皮病变位置、大小、形态、囊实性及与颅骨、颅内的关系等,是临床重要的检查方法.     

早期强直性脊柱炎骶髂关节病变低场MRI诊断

目的 探讨低场MRI对早期强直性脊柱炎(AS)骶髂关节(SIJ)的诊断.方法 对46例AS的SIJ进行MRI横、斜冠状位扫描,包括快速自旋回波(FSE) T2WI,自旋回波(SE)T1WI,快速自旋回波(FSE- XL) T2WI+ 脂肪抑制,3D FW FGRE T2WI.男33例,女13例,年龄15～46岁,平均22.6岁.结果 46例早期AS骶髂关节MRI表现的患者中,Ⅰ级18例(34.8%),Ⅱ级28例(65.2%).骶髂关节单侧受累15例(32.6%),双侧同时受累31例(67.4%).早期MRI表现为骨髓水肿、关节软骨异常分别有38个、28个,骨质侵蚀20个,骨质硬化12个.结论 MRI有利于显示AS的SIJ早期表现,可为临床治疗提供客观依据.     

Apparent diffusion coefficients of sacroiliitis in patients with established ankylosing spondylitis

AimTo compare apparent diffusion coefficients (ADCs) of sacroiliac joints (SIJs) in ankylosing spondylitis (AS) patients during advanced-active and advanced-nonactive stages.Materials–MethodsAS patients with chronic-active (n= 19), chronic-nonactive (n= 6), and controls with normal SIJs (n= 8) were included. Mean ADCs through 43 subchondral bone marrow edema lesions (SBMELs) were calculated.ResultsMean ADCs were 1.60 +/? 0.32×10–3 mm²/s over SBMELs, 0.57 +/? 0.23×10–3 mm²/s at periphery of SBMELs, 0.57 +/? 0.24×10–3 mm²/s in chronic-nonactive group, and 0.61 +/? 0.19×10–3 mm²/s for controls.ConclusionADCs lower than 0.69×10–3 mm²/s, obtained at subchondral aspect of SIJs of established AS patients with chronic changes, which this number represents the receiver operating characteristic (ROC) best cutoff value, can be considered as normal without possible residual inflammation of concern.     

强直性脊柱炎骶髂关节核素骨显像与病理分析

目的 探讨核素骨显像骶髂关节与骶骨放射性比值测定诊断强直性脊柱炎（AS）的价值。方法 16例AS患者，共31个骶髂关节，CT检查诊断为0、Ⅰ、Ⅱ、Ⅲ、Ⅳ期骶髂关节炎。先行全身骨显像、骶髂关节显像及放射性比值测定，1－3d后行CT引导下骶髂关节穿刺活组织检查。结果 活组织检查示骶髂关节炎关节30个，均有不同程度的滑膜炎、软骨及软骨下骨板血管翳侵入、骨质破坏等病变。核素骶髂关节显像示放射性比值升高关节27个。16例患者均有全身其他关节或脊柱病变。结论 核素骨显像及其放射性比值测定有利于AS骶髂关节炎搂早期诊断，对其活动性监测有临床价值。     

mDixon Quant脂肪定量技术对强直性脊柱炎骶髂关节炎的应用研究

目的 探讨mDIXON Quant脂肪定量技术在强直性脊柱炎骶髂关节病变中的应用价值。方法 收集诊断明确的强直性脊柱炎患者63名,20名健康志愿者。所有受试者均行双侧骶髂关节常规扫描、mDIXON Quant检查。观察患者的影像表现、BASDAI评分、实验室指标将患者分为3组：早期活动组、慢性活动组、非活动组,在mDIXON Quant序列脂肪分数映射图中测量三组骨髓水肿区、脂肪沉积区以及四组病变外区的脂肪分数,比较早期活动组、慢性活动组骨髓水肿病灶以及慢性活动组、非活动组的脂肪沉积病灶脂肪分数的差异。应用单因素方差分析比较4组间病变外区骨髓的脂肪分数的差异。结果 骨髓水肿灶的脂肪分数：慢性活动组高于早期活动组,脂肪分数分别为（30.0±10.6）％、（20.3±10.2）％,脂肪沉积区的脂肪分数：非活动组高于慢性活动组,脂肪分数分别为（89.4±1.1）％、（81.6±1.7）％,病变外区骨髓的脂肪分数,四组间脂肪分数差异无统计学意义（F=1.37,P＞0.05）。结论 mDIXON Quant技术通过测量脂肪分数,可以量化骶髂关节炎骨髓水肿区、脂肪沉积区的脂肪含量,在判断病情变化中具有价值。     

Value of DWI in visual assessment of activity of sacroiliitis in longstanding ankylosing spondylitis patients

Objective

To test contrast to noise ratios (CNRs) of both diffusion-weighted (DW) images and contrast enhanced images in terms of the visual assessment of activity in sacroiliitis of ankylosing spondylitis (AS) patients.

Materials and methods

The study included 21 patients with AS. All patients were examined with STIR, FST1/Gd and DWI (b?=?0,600). A total of 54 hyperintense lesions on STIR were noted in their sacroiliac joints divided into four quadrants. CNRs were calculated for all of the sequences above. A second group of patients (n?=?7) with normal sacroiliac joints (SIJs) served as controls. A total of 56 CNR measurements from apparently normal subchondral bone marrow in this control group were done as well. The differences between scores were tested for significance (SPSS version 17.0) using Wilcoxon's test in which p values lower than 0.01 were considered statistically significant.

Results

In the first group with sacroiliitis, mean CNRs for STIR, FST1/Gd, DWI were 32.97, 30.16 and 24.47, respectively. Mean CNRs in the second group with normal SIJs were calculated as 3.52 , 2.99 and 3.96, respectively . There was a statistically significant difference between the CNR measurements of the first and the second group (p?=?0.000). Hyperintense lesions on STIR were depicted as "active" in the first group. Except for four lesions that were not included into the study, all of these hyperintense lesions were enhanced after contrast media administration. All of the "active" lesions were observed on DWI as well, at b?=?600. No statistically significant difference between CNRs of contrast enhanced images and DWI and of contrast enhanced images and fluid sensitive sequences were found in the first group with sacroiliitis (p?>?0.01).

Conclusion

The CNRs are highest on STIR, followed by contrast enhanced images and DWIs. In terms of DWI and contrast enhanced images, there is no statistically significant difference between these two. Hence, contrast enhanced imaging can be replaced by DWI for visual analysis of active sacroiliitis, which is easy to apply without adverse affects of contrast media.