强直性脊柱炎骶髂关节的CT表现(附80例病例分析)

目的总结强直性脊柱炎骶髂关节的CT表现.方法分析80例临床诊断肯定的强直性脊柱炎病例的骶髂关节CT检查资料.结果80例中73例骶髂关节有异常表现,包括1、早期(1)双侧关节对称性受累,极少数可单侧受累;(2)骨关节面毛糙、皮质白线消失;(3)骨关节面皮质中断;(4)关节面下微小囊变;(5)骶髂关节髂骨面轻度硬化.2、进展期(中期)(1)骶髂关节关节面不光整,局部呈锯齿状或毛刷样改变;(2)骶髂关节关节面下小囊状骨质破坏;(3)关节面周围明显增生硬化;(4)关节间隙假性增宽;(5)关节间隙不规则狭窄;(6)关节间隙不规则真空.3、稳定期(晚期)(1)韧带骨化;(2)关节骨性强直、关节间隙消失;(3)明显骨质疏松、硬化.结论骶髂关节CT检查有助于强直性脊柱炎的早期诊断,提高诊断的准确性.且有助于临床对病程分期.

CT Findings of Sacroiliac Joints in Ankylosing Spondylitis(An Analysis of 80 Cases)

Objective To sum up CT findings of sacroiliac joints in ankylosing spondylitis with an attempt at further improving early and even accurate diagnosis of the disease.Methods CT features of sacroiliac joints in 80 cases with anklyosing spondylitis proved clinically were analysed,and their application in making the diagnosis was evaluated.Results 73 of the 80 cases had abnormal CT findings of the joints,with different features according to different stages of the disease.In early stage,most cases were with symmetric involvement of the joints showing shaggy appearance of the articular surface with interruption or disappearance of the joint cortex,subcortical microcysts and mild sclerosis of iliac surface of joint .In advanced stage,cases were with irregularity of sacroiliac articular surfaces,showing serrated or brush-like appearance,subcortical systic destruction,sclerosis or hypertrophic changes around the joints,and pseudo-widening,irregular narrowing or even vacuumization of the joint space.In the late or stable stage,ossification of ligaments,bony ankylosis of the joints with obliteration of joint space and osteoporosis or osteosclerosis were seen.Conclusion CT study of sacroiliac joints could be helpful in making an early and even accurate diagnosis of ankylosing spondylitis as well as in clinical staging of the disease.