螺旋CT在强直性脊柱炎骶髂关节病变诊断中的应用价值探讨

目的:探讨螺旋CT在强直性脊柱炎骶髂关节病变诊断中的临床应用价值。方法:选择强直性脊柱炎骶髂关节病变患者99例,所有患者均接受普通X线平片及多层螺旋CT检查。比较两者对疾病的分期及对各种征象的显示情况。结果:1.螺旋CT对Ⅰ级和Ⅱ级病变的检出率显著高于X线平片,其差异有统计学意义(P<0.05)。在Ⅲ级和Ⅳ级病变的检出中,两种检查方法无统计学差异(P>0.05)。2.螺旋CT对关节面侵蚀、关节面下骨质囊变、腰5骶1关节突病变及软组织肿胀的显示率均显著高于X线平片(P<0.05)。在对关节增生硬化、关节间隙增宽或狭窄、关节强直的显示中,两种检查方法无统计学差异(P>0.05)。结论:螺旋CT在强直性脊柱炎骶髂关节病变诊断中具有很高的应用价值。

Value of spiral CT in the diagnosis of sacroiliac joint lesion in ankylosing spondylitis

Objective:To investigate the clinical value of spiral CT in the diagnosis of sacroiliac joint lesion in ankylosing spondylitis.Methods:A total of 99 patients with sacroiliac joints lesion in ankylosing spondylitis were chosen,all patients underwent X-ray and spiral CT examination within 3 days after admission.The images were observed and compared among patients with different stage and different signs.Results:The detection rate of Spiral CT of class I and class II lesions was significantly higher than the X-ray film,the difference was statistically significant(P<0.05).For the detection of grade III and IV grade lesions,the two methods had no significant difference(P>0.05).Spiral CT had significantly higher detection rate than the X-ray plain film in detecting articular surface erosion,articular surface of the bone cystic degeneration,L5/S1 the zygapophysial lesions and soft tissue swelling(P<0.05).But the difference was not significant in detecting joint hyperplasia,sclerosis,joint space widening or narrow,and joint stiffness difference(P>0.05).Conclusions:Spiral CT is valuable in the diagnosis of sacroiliac joints lesion in ankylosing spondylitis.