X线 CT和磁共振成像在早期强直性脊柱炎骶髂关节病变诊断中的应用价值对比分析

目的分析X线、CT、磁共振成像(MRI)3种检查手段诊断早期强直性脊柱炎骶髂关节病变的应用价值。方法选择我院2018年1月至2019年1月收治的46例早期强直性脊柱炎骶髂关节病变患者开展研究,所有患者均进行X线检查、MRI检查、CT检查,比较3种检查方法的疾病检出率。结果对早期强直性脊柱炎骶髂关节病变典型影像学表现(关节软骨肿胀关节面侵蚀关节面下骨质囊变)的检出率,X线分别是0、52%、39%,MRI为:9%、83%、70%;CT为4%、76%、59%;X线检出率明显低于MRI、CT,比较差异有统计学意义(P<0.05),MRI与CT检出率相差不大,比较差异无统计学意义(P>0.05)。对该病的病变分级总检出率中,X线为48%,CT为85%,MRI为96%,在早期病变(0~Ⅱ级)的检出率中,X线为26%,CT为59%,MRI为65%,X线、CT、MRI在病变分级总检出率、0~Ⅱ级病变检出率的比较差异均有统计学意义(P<0.05),但是在Ⅲ、Ⅳ级病变检出率中差异无统计学意义(P>0.05)。结论X线、CT、MRI检查手段诊断早期强直性脊柱炎骶髂关节病变都具有一定的诊断价值,但MRI的检出率最高,能够准确显示出病变情况,MRI更具诊断优势及应用价值。

The value of X-ray CT and MRI in the diagnosis of sacroiliac joint lesions in early ankylosing spondylitis

Objective To analyze the value of X-ray,CT and MRI in the diagnosis of sacroiliac joint lesions in early ankylosing spondylitis.Methods Forty-six cases with early ankylosing spondylitis with sacroiliac joint lesions admitted to our hospital from January 2018 to January 2019 were studied.All patients underwent X-ray,MRI and CT examinations to compare the disease detection rates of the three methods.Results The detection rate of typical imaging manifestations of sacroiliac joint lesions in early ankylosing spondylitis such as swelling of articular cartilage,articular erosion and subarticular bone cystic changes by X-ray was 0,52%,39%respectively,while MRI was 9%,83%,70%,and CT was 4%,76%,59%.The detection rates of X-ray were significantly lower than those of MRI and CT(P<0.05),but there was no significant difference between MRI and CT(P>0.05).The total detection rate of pathological grading of the disease by X-ray was 48%,while CT was 85%,and MRI was 96%.The detection rate of early pathological changes(grade 0~Ⅱ)by X-ray was 26%,while CT was 59%,and MRI was 65%.The difference in the total detection rate of pathological grading and the detection rate of grade 0~Ⅱpathological changes between X-ray,CT and MRI had statistical significance(P<0.05),but there was no difference in the detection rate of grade Ⅲ and Ⅳ pathological changes(P>0.05).Conclusion X-ray,CT and MRI examination have certain diagnostic value in the diagnosis of sacroiliac joint lesions in early ankylosing spondylitis,but the detection rate of MRI is the highest,which can accurately show the lesions.MRI has more diagnostic advantages and application value.