强直性脊柱炎患者放射性核素骨显像分析

目的　研究放射性核素骨显像对强直性脊柱炎 (AS)的诊断价值。方法　AS患者和对照组均做了全身、局部及断层骨显像 ,并测定了骶髂关节 /骶骨 (SI/S)的计数比值。结果　早期AS患者的SI/S比值 (1.5 3± 0 .11)与对照组 (1.2 1±0 .10 )、中期 (1.2 8± 0 .2 9)和晚期 (1.19± 0 .3 9)AS患者比较 ,均有显著性差异 (P <0 .0 1) ;中期和晚期AS患者的SI/S比值之间 ,以及中、晚期AS患者的SI/S比值与对照组比较 ,均无差异 (P >0 .0 5 )。 6例X线平片无异常的AS患者全身骨显像则发现腰椎及外周关节放射性异常浓聚 ;AS患者全身骨显像共发现椎骨异常浓聚灶 2 43个 ,而断层显像则检出 3 0 9个异常浓聚灶。结论　放射性核素骨显像测定SI/S比值对AS早期诊断有重要价值 ;对中、晚期AS的诊断意义不大 ;骨显像发现AS骨关节部位的早期病变比X线平片更敏感 ;断层显像对了解AS椎骨诸关节病变比平面显像具有明显的优势

The Analysis of Radionuclide Bone Imaging on Ankylosing Spondylitis

Objective To research the diagnostic value of radionuclide bone imaging on ankylosing spondylitis (AS). Methods Patients with AS and control group underwent ^99m Tc-MDP whole-body, local and SPECT bone imaging, and the sacroiliac/sacral (SI/S) ratios were determined. Results The SI/S ratios of patients with early stage of AS (1.53±0.11) were all significantly increased compared with control group (1.21±0.10) and patients with middle (1.28±0.29)and late stage of AS (1.19±0.39) (P<0.01); The SI/S ratios between middle and late stage of AS patients were undifferentiated (P>0.05); The SI/S ratios of patients with middle and late stage of AS were not different compared with control group (P>0.05); Whole-body bone imaging showed the lumbar vertebrae and other joint diseases of 6 patients with AS not found in plain film. Whole-body bone imaging showed 243 lesion of vertebral joints of patients with AS, whereas SPECT bone imaging found 309 lesion of vertebral joints. Conclusion The SI/S ratios determined with radionuclide bone imaging were valuable on early diagnosis of AS and not significant on diagnosis of middle and late AS; Bone imaging were more sensitive than plain film to find the early lesion of joint disease of patients with AS. SPECT bone imaging was obviously profitable than plain imaging to observe the lesion of vertebral joint.