强直性脊柱炎骶髂关节病变的早期影像学诊断

目的 探讨强直性脊柱炎骶髂关节病变早期的影像学诊断价值.方法 收集经临床确诊的21个强直性脊柱炎早期病例,回顾分析其骶髂关节DR、CT及MRI表现.结果 DR仅发现5例骶髂关节可疑异常.CT显示19例骶髂关节病变,主要表现有关节面皮质白线中断（17例）,局部骨质硬化（14例）,骨皮质下小囊样改变（8例）.MRI显示21例关节均为异常,主要表现有关节面下骨髓水肿（21例）,关节软骨破坏（20例）;9例行增强扫描,关节面下骨髓（9例）、滑膜（6例）、关节软骨（8例）及关节韧带（5例）呈现不同程度强化.结论 强直性脊柱炎的早期影像学诊断,X线检查最为基本,但诊断意义有限;CT对分级较为客观,且能较好地显示骨质病变情况;MRI具有明显优势,结合临床,可做出早期诊断.

Imaging diagnosis of early sacraoiliac joint lesions in ankylosing spondlitis

Objective To study the diagnostic value of imageology for early sacraoiliac joint lesions in ankylosing spondlitis（AS）. Methods A retrospective analysis was made on the manifestations of DR, CT and MRI of the sacraoiliac joints in 21 cases with early AS lesions confirmed by clinic. Results Only 5 cases of the sacraoiliac joints that suspicious singular were found in DR. CT findings 19 cases of the sacraoiliac joints are pathological changes, interrupted joint cortex （ 17 cases）, bone sclerosis parcel （ 14 cases）, cystic change of the articular sub - surface bone structure （8 cases）. MRI findings 21 cases of the sacraoiliac joints are pathological changes, bone marrow edema at the articular sub -surface （21 cases）, ar- ticular- cartilage damage （20 cases）. 9 cases had enhanced scanning, the bone marrow （9 cases） , the synovial （6 cases） , articular - cartilage （8 cases）, the joint ligament （5 cases） showed different degrees of strengthening. Conclusion For the imaging diagnostic of early lesions in ankylosing spondlitis, DR examination is the basic method that the value is very. limited. CT in grading lesions is more external, and can show the bone lesions more clearly. There is obvious advantage on MRI, by which AS can be early diagnosed with clinical.