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强直性脊柱炎骶髂关节影像学分析(附24例骶髂关节平片、CT和MR影像对比观察)
引用本文:余卫,冯逢,严洪珍,蒋明,王林辉.强直性脊柱炎骶髂关节影像学分析(附24例骶髂关节平片、CT和MR影像对比观察)[J].中华放射学杂志,1997(11).
作者姓名:余卫  冯逢  严洪珍  蒋明  王林辉
作者单位:北京市中国医学科学院中国协和医科大学北京协和医院放射科
摘    要:目的:旨在评估强直性脊柱炎(AS)患者骶髂关节炎的MR影像特征,并比较X线平片、CT和MR影像在诊断骶髂关节炎中的作用。材料与方法:搜集24例AS患者,分别行X线平片、CT和MRI检查。增强前MR扫描序列包括SET1WI、FSET2WI和梯度回波的准T2WI(GRT2*WI)。增强后MR扫描序列参数与增强前SET1WI相同。另选9例志愿者,行MR平扫检查。结果:8例志愿者16个骶髂关节的T1WI和T2WI可直接显示正常骶髂关节软骨,表现为线形或点样的中等信号影。9例志愿者11个骶髂关节的骨髓内可见局灶性脂肪沉积。24例AS患者的42个骶髂关节可见软骨异常,表现为T1WI和T2WI上正常线形中等信号的软骨影像消失,代之以不规则增粗或扭曲样中等信号。分析表明:在骶髂关节炎的诊断方面,MR和CT明显优于X线平片(P<0.001)。结论:同X线片比较,虽CT和MRI均有助于AS骶髂关节炎的诊断,但MR影像可显示CT和X线所不能显示的软骨异常和骨髓内水肿改变;骨髓内脂肪沉积可属正常变异;扭曲样中等强度信号应视为软骨的异常征象。

关 键 词:骶髂关节  脊柱炎.强直性  体层摄影术.X线计算机  磁共振成像  放射摄影术

Comparison of radiography, computed tomography and magnetic resonance imaging in the detection of sacroiliitis for ankylosing spondylitis
Yu Wei,Feng Feng,Yan Hongzhen,et al..Comparison of radiography, computed tomography and magnetic resonance imaging in the detection of sacroiliitis for ankylosing spondylitis[J].Chinese Journal of Radiology,1997(11).
Authors:Yu Wei  Feng Feng  Yan Hongzhen  
Institution:Yu Wei,Feng Feng,Yan Hongzhen,et al. Department of Radiology,PUMC Hospital,Beijing 100730
Abstract:Purpose: To evaluate characteristics of sacroiliitis on MR imaging and to compare the MR images with findings obtained by conventional radiography and CT in patients with ankylosing spondylitis (AS). Materials and methods: Twenty four AS patients were recruited. In each patient the conventional radiography, CT and MR imaging were completed within a week interval. In pre contrast MR examination, SE T 1, FSE T 2 and GR T 2 * weighted images were chosen. Post contrast MR examination was performed using the same SE T 1 sequence as the pre contrast MR examination. Another 9 healthy volunteers underwent the same examinations as the pre contrast MR imaging. Results: MR imaging directly showed the cartilage in the synovial compartment as a thin linear or dot zone of intermediate signal intensity on both T 1 and T 2 weighted images in all 16 sacroiliac (SI) joints of the 8 volunteers. Of the 11 SI joints in 9 volunteers, focal fat signal intensities were observed as higher signal intensity on both T 1, T 2 or T 2 * weighted images in the areas of bone marrow. Of 42 SI joints in 24 AS patients were observed the cartilage abnormalities. Cartilage abnormalities were shown either to loss of the normal thin zone of intermediate signal intensity or to become thick, irregular and crooked intermediate signal intensity on T 1 or T 2 weighted images. The sacroiliitis diagnosed by MR imaging and CT were significantly more than those by radiography ( P <0.001). Conclusion: Comparing with radiographs, both CT and MR are helpful to the diagnosis of sacroiliitis in patients with AS. MR can reveal the abnormality of cartilage and bone marrow edema, which cannot shown on both CT and radiographs. Normal variant should be considered as the explanation for the fat accumulation in the bone marrow. The crooked intermediate signal should be considered as another abnormal cartilage sign.
Keywords:Sacroiliac joint    Spondylitis  ankylosing    Tomography  X  ray computed    Magnetic resonance imaging    Radiography  
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