影像学对强直性脊柱炎骶髂关节病变的诊断价值

目的探讨强直性脊柱炎(AS)骶髂关节改变的影像学诊断价值。方法回顾性分析98例经临床证实的AS患者的骶髂关节CR、CT及MRI表现特点,包括分级、部位和数量、钙化、关节间隙变化及关节面下骨质改变等。结果AS骶髂关节病变的CR正位及斜位片显示:骶髂关节间隙变窄67例,关节面致密硬化22例,囊变15例,关节强直17例,钙化38例;CT显示:病变主要累及骶髂关节滑膜部髂骨侧,软骨钙化55例,关节间隙变窄42例,关节面及面下骨质结构囊变43例,硬化65例,骶髂韧带钙化52例;MRI显示:关节软骨破坏40例,病变区周围水肿57例,骨内脂肪沉积15例。结论对AS骶髂关节的检查,CR为最基本的方法,CT对AS的分级较准确,而MRI对AS骶髂关节病变可做出早期诊断。

Diagnostic Value of Imageology for Sacraoiliac Pathological Changes in Ankylosing Spondylitis

Objective To study the diagnostic value of imageology(CR,CT and MRI) for sacraoiliac pathological changes(SIPC) in ankylosing spondylitis(AS).Methods A retrospective analysis was made on the manifestations of CR,CT and MRI of the sacraoiliac joints in 98 cases of clinically-proved AS,including the grading,site and number,calcification,joint-space and sub-articular-surface-bone changes.Results The characteristics of AS in sacraoiliac joint on CR were: joint-space narrowing(67),articular-surface sclerosis(22),cystic change(15) and joint stiffness(17) and calcification(38).CT features were:the lesions involving iliac-side synovium of the sacraoiliac joint mainly,chondral calcification(55),joint-space narrowing(42),cystic change(43) and sclerosis(65) of the articular surface and sub-surface bone structure,and calcification of sacraoiliac-ligament(52).MRI showed: articular-cartilage damage(40),edema around the lesion(57) and intrabony fat sedimentation(15).Conclusion For sacraoiliac joint in AS,CR examination is the basic imaging method,CT in grading lesions is more accurate,while SIPC in AS can be early diagnosed by MRI.