AS髋关节受累影像学表现与临床特点相关性探讨
发布时间：2018-09-19 08:16
【摘要】：目的:通过对AS患者一般情况、临床表现、实验室检查、影像学检查、诊治情况等结果对比,探讨不同影像学检查在诊断AS患者髋关节受累中的价值及影像学表现与临床特点之间相关性。方法:收集患者一般信息、临床表现、实验室检查、影像学检查(骨盆X线平片、髋关节CT及MRI)、诊治情况等资料,应用独立样本T检验及Χ2检验对结果进行分析。结果:117例AS患者234侧髋关节中,X线平片显示异常为46侧,MRI显示异常为151侧;X线平片显示异常包括:间隙狭窄:34侧,股骨头密度不均:15侧,骨质破坏:20侧,骨质硬化:10侧,骨质增生:8侧;MRI显示异常包括:关节积液:110侧,滑膜增厚:12侧,滑膜强化:21侧,骨髓水肿:79侧,肌腱端炎:1侧,骨质破坏:15侧,间隙变窄:10侧,脂肪沉积:4侧。行CT检查的88例共176侧髋关节中,异常关节数为60侧,其中35侧骨破坏未能在X线平片中显示,43侧骨破坏未能在MRI中显示。X线平片、CT、MRI显示髋关节异常分别为18.8%(33/176)、34.1%(60/176)和63.6%(112/176),在影像学显示髋关节受累的敏感度方面,MRI优于X线平片和CT(X2值分别为73.19和30.74,P值均0.05)。有髋关节影像学慢性骨结构改变的患者较无慢性骨结构改变的患者发病年龄小、病程短、病史中有更多髋关节疼痛或活动受限、BASFI高(P均0.05)。相对于病史中无髋关节疼痛或活动受限的患者,病史中有髋关节疼痛或活动受限的患者以颈部为首发症状的患者少、出现髋关节影像学慢性骨结构改变较多(P均0.05),既往接受正规专科治疗较多(P0.05),余(P均0.05)差别无统计学意义。结论:在诊断AS髋关节受累的影像学检查中,骨盆X线平片只能发现中、晚期病变,可用于疾病筛查;X线平片、CT和MRI均能显示AS髋关节受累的慢性骨结构改变,但在显示髋关节间隙狭窄方面X线平片敏感度最优,在显示微小骨质破坏方面,CT敏感度最优;X线平片和CT不能显示MRI能显示的急性炎性期改变。发病年龄小、病程短、BASFI高、病史中有髋部疼痛或活动受限的AS患者更易出现髋关节影像学慢性骨结构改变;以膝关节炎为首发症状的AS患者病程中不易发生髋关节慢性骨结构改变。以颈部疼痛或活动受限为首发症状的患者病史中出现髋部疼痛或活动受限较少,有髋关节疼痛或者活动受限的患者更易出现髋关节影像学慢性骨结构破坏,更易就诊及接受正规专科治疗。
[Abstract]:Objective: to compare the general situation, clinical manifestation, laboratory examination, imaging examination, diagnosis and treatment of AS patients. To explore the value of different imaging examination in the diagnosis of hip involvement in patients with AS and the correlation between imaging findings and clinical features. Methods: the data of general information, clinical manifestation, laboratory examination, imaging examination (pelvis plain film, CT and MRI), diagnosis and treatment of hip joint) were collected, and the results were analyzed by independent sample T test and X 2 test. Results among the 234 cases of AS, 46 sides were abnormal in MRI, 34 sides in narrow space, 15 sides in uneven density of femoral head, 20 sides in bone destruction, 10 sides in bone sclerosis, 10 sides of bone sclerosis, 34 sides of narrow gap, 15 sides of uneven density of femoral head, 20 sides of bone destruction, 10 sides of bone sclerosis. The MRI findings of 8 sides of osteomatous hyperplasia included: synovial thickening: 1 / 110, synovial thickening: 12, synovial enhancement: 21, bone marrow edema: 1: 79, tendonitis: 1, bone destruction: 15, gap narrowing: 10, fat deposition: 4. The abnormal number of hip joints was 60 in 88 patients with 176 sides of hip joint examined by CT. Among them, 35 sides of bone destruction could not be shown in X-ray plain film. 43 sides of bone destruction could not be displayed in MRI. The abnormal rate of hip joint was 18.8% (33 / 176), 34.1% (60 / 176) and 63.6% (112 / 176), respectively. MRI was superior to X-ray plane in the sensitivity of imaging showing hip involvement. CT and X _ 2 values were 73.19 and 30.74 (P < 0. 05, respectively). The patients with chronic bone structure changes in hip imaging were younger than those without chronic bone structure changes, the course of disease was shorter, and there were more hip pain or limited movement in the history (all P 0.05). The neck was the first symptom in patients with history of hip pain or limited movement, compared with those with no hip pain or limited movement. There were more chronic bone structure changes in hip imaging (all P 0.05), more regular specialist treatment in the past (P0.05), and no significant difference in the rest (P 0.05). Conclusion: in the imaging examination of AS hip joint involvement, pelvic X-ray plain film can only find middle and late lesions, and can be used to screen the disease screening X ray plain film CT and MRI can show the chronic bone structure changes of AS hip joint involvement. But the X-ray radiographic sensitivity was the best in showing the stenosis of the hip joint space, and the CT sensitivity was the best in showing the small bone destruction. The X-ray plain film and CT could not show the acute inflammatory phase changes that MRI could show. AS patients with low onset age, short course of disease and high BASFI, with history of hip pain or limited movement, were more likely to have chronic bone structure changes in hip joint imaging. Chronic bone structure changes of hip joint are not easy to occur in patients with AS with knee arthritis as the first symptom. Patients with neck pain or limited movement were less likely to suffer from hip pain or motion restriction in their history, and those with hip pain or motion limitation were more likely to suffer from chronic bone structure destruction in hip imaging. It is easier to see a doctor and receive regular specialist treatment.
【学位授予单位】：石河子大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R593.23
本文编号：2249559
[Abstract]:Objective: to compare the general situation, clinical manifestation, laboratory examination, imaging examination, diagnosis and treatment of AS patients. To explore the value of different imaging examination in the diagnosis of hip involvement in patients with AS and the correlation between imaging findings and clinical features. Methods: the data of general information, clinical manifestation, laboratory examination, imaging examination (pelvis plain film, CT and MRI), diagnosis and treatment of hip joint) were collected, and the results were analyzed by independent sample T test and X 2 test. Results among the 234 cases of AS, 46 sides were abnormal in MRI, 34 sides in narrow space, 15 sides in uneven density of femoral head, 20 sides in bone destruction, 10 sides in bone sclerosis, 10 sides of bone sclerosis, 34 sides of narrow gap, 15 sides of uneven density of femoral head, 20 sides of bone destruction, 10 sides of bone sclerosis. The MRI findings of 8 sides of osteomatous hyperplasia included: synovial thickening: 1 / 110, synovial thickening: 12, synovial enhancement: 21, bone marrow edema: 1: 79, tendonitis: 1, bone destruction: 15, gap narrowing: 10, fat deposition: 4. The abnormal number of hip joints was 60 in 88 patients with 176 sides of hip joint examined by CT. Among them, 35 sides of bone destruction could not be shown in X-ray plain film. 43 sides of bone destruction could not be displayed in MRI. The abnormal rate of hip joint was 18.8% (33 / 176), 34.1% (60 / 176) and 63.6% (112 / 176), respectively. MRI was superior to X-ray plane in the sensitivity of imaging showing hip involvement. CT and X _ 2 values were 73.19 and 30.74 (P < 0. 05, respectively). The patients with chronic bone structure changes in hip imaging were younger than those without chronic bone structure changes, the course of disease was shorter, and there were more hip pain or limited movement in the history (all P 0.05). The neck was the first symptom in patients with history of hip pain or limited movement, compared with those with no hip pain or limited movement. There were more chronic bone structure changes in hip imaging (all P 0.05), more regular specialist treatment in the past (P0.05), and no significant difference in the rest (P 0.05). Conclusion: in the imaging examination of AS hip joint involvement, pelvic X-ray plain film can only find middle and late lesions, and can be used to screen the disease screening X ray plain film CT and MRI can show the chronic bone structure changes of AS hip joint involvement. But the X-ray radiographic sensitivity was the best in showing the stenosis of the hip joint space, and the CT sensitivity was the best in showing the small bone destruction. The X-ray plain film and CT could not show the acute inflammatory phase changes that MRI could show. AS patients with low onset age, short course of disease and high BASFI, with history of hip pain or limited movement, were more likely to have chronic bone structure changes in hip joint imaging. Chronic bone structure changes of hip joint are not easy to occur in patients with AS with knee arthritis as the first symptom. Patients with neck pain or limited movement were less likely to suffer from hip pain or motion restriction in their history, and those with hip pain or motion limitation were more likely to suffer from chronic bone structure destruction in hip imaging. It is easier to see a doctor and receive regular specialist treatment.
【学位授予单位】：石河子大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R593.23
【参考文献】
相关期刊论文 前3条
1 谭魁麟,程秀峰,谭军,陈晓翔,景成定,刘琴芳;磁共振成像检查对强直性脊柱炎髋关节病变的意义[J];中华风湿病学杂志;2003年02期
2 李永琴;;AS髋关节改变的CT和MRI对比研究[J];河北医学;2014年09期
3 尚燕宁,赵天佐,张雪哲,孙海军;强直性脊柱炎骶髂关节和髋关节的CT表现[J];中日友好医院学报;2005年01期
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