中轴型血清阴性脊柱关节病骶髂关节功能磁共振成像肌水肿与骨质改变的关系

发布时间：2018-04-05 13:39

本文选题：脊柱关节病　切入点：磁共振成像　出处：《复旦学报(医学版)》2017年02期

【摘要】：目的观察中轴型血清阴性脊柱关节病(spondyloarthropathy,SpA)患者骶髂关节功能磁共振成像肌及骨质改变情况,分析两者之间的关系。方法采用Siemens aera1.5T磁共振扫描仪,用高通道体表线圈,对符合2009年中轴型血清阴性SpA诊断标准的38例患者进行骶髂关节磁共振扫描,观察肌及骨质改变情况。根据磁共振成像,将入组患者分为肌水肿阳性组及阴性组,对两组患者磁共振图像骨质改变进行影像学评分,包括加拿大脊柱骨关节研究协会评分(SPARCC)以及骶髂关节骨质结构性改变评分(SPARCC SSS)。分析两组间影像评分的统计学差异,将患者骶髂关节周围肌受累范围分为0~12等级,对肌水肿受累范围不同等级与上述指标进行Spearman等级相关性检验。结果38例患者中28例(73.68%)患者具有明显肌水肿,竖脊肌22例(57.89%),臀肌13例(34.21%),髂肌11例(28.95%),闭孔内肌5例(13.16%),梨状肌5例(13.16%),其他4例(10.53%)。患者均有不同程度骨髓水肿及结构性改变;肌水肿阳性组及阴性组两组间SPARCC(t=2.28,P=0.03)、SPARCC SSS(t=3.37,P=0.00)差异均有统计学意义。SPARCC(P=0.00,r=0.67)、SPARCC SSS(P=0.01,r=0.47)均与肌水肿受累范围存在正相关。结论骶髂关节周围肌水肿为中轴型血清阴性SpA磁共振检查的重要征象,伴有肌炎性水肿者骨质改变更严重。
[Abstract]:Objective to observe the changes of sacroiliac joint functional MRI muscle and bone in patients with spondyloarthropathy SpA (SpA) and to analyze the relationship between them.Methods the sacroiliac joint was scanned by Siemens aera1.5T magnetic resonance scanner with high channel surface coil in 38 patients who met the diagnostic criteria of medial axis sero-negative SpA in 2009. The changes of muscle and bone were observed.According to magnetic resonance imaging, the patients were divided into positive group and negative group.These include the Canadian Spine and Bone Joint Research Association score SPARCC) and the sacroiliac joint bone structural change score SPARCC SSSX.By analyzing the statistical difference of imaging scores between the two groups, the range of involvement of the sacroiliac joint was divided into 0 and 12 grades, and the correlation between the range of involvement of muscle edema and the above indexes was tested by Spearman grade correlation test.Conclusion Periarticular edema of sacroiliac joint is an important sign of axial sero-negative SpA magnetic resonance imaging, and the bone changes are more serious in patients with myoinflammatory edema.
【作者单位】：上海市影像医学研究所;复旦大学附属中山医院放射科;复旦大学附属中山医院风湿免疫科;西门子(深圳)磁共振有限公司;
【分类号】：R681.5

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