多普勒超声在早期活动性中轴型脊柱关节病中的应用

发布时间：2018-07-07 07:24

本文选题：脊柱关节病 + 骶髂关节炎　；参考：《中国医学影像技术》2017年08期

【摘要】：目的探讨多普勒超声诊断中轴型脊柱关节病(axSpA)患者活动性骶髂关节炎的价值。方法回顾性分析51例早期axSpA患者的多普勒超声及MRI资料。依据MRI结果将axSpA患者分为活动性骶髂关节炎(活动)组及非活动性骶髂关节炎(非活动)组,比较2组骶髂关节的血流显示情况及血流阻力指数(RI)。以MRI结果为金标准,绘制ROC曲线,评价RI对axSpA患者活动性骶髂关节炎的诊断效能。结果活动组32例共58个病变关节(6例为单发活动性骶髂关节炎),非活动组19例共38个病变关节。活动组骶髂关节血流显示率(51/58,87.93%)高于非活动组(26/38,68.42%;χ~2=5.505,P=0.019)。2组间血流分级差异无统计学意义(Z=-1.93,P=0.053)。活动组RI值(0.59±0.08)低于非活动组(0.71±0.09;t=-6.04,P0.001)。以RI=0.64诊断axSpA患者活动性骶髂关节炎,敏感度为80.8%,特异度为74.5%,准确率为78.7%。结论利用多普勒超声可通过骶髂关节周围及内部的异常血流来反映axSpA患者活动性骶髂关节炎,且准确率较高。
[Abstract]:Objective to evaluate the value of Doppler ultrasonography in the diagnosis of active sacroiliac arthritis in patients with axial spondyloarthropathy (axspa). Methods the Doppler ultrasound and MRI findings of 51 patients with early axspa were retrospectively analyzed. Patients with axspa were divided into active sacroiliac arthritis (active) group and inactive sacroiliac arthritis (inactive) group according to MRI results. The blood flow display and blood flow resistance index (RI) of sacroiliac joint were compared between the two groups. Using MRI results as gold standard, the ROC curve was drawn to evaluate the diagnostic efficacy of RI for active sacroiliac arthritis in patients with axspa. Results there were 58 diseased joints (6 cases of single active sacroiliac arthritis) in active group and 38 cases in inactive group (19 cases). The blood flow display rate of sacroiliac joint in the active group (51 / 58) was higher than that in the inactive group (26 / 38) (68.42). The RI of the active group (0.59 卤0.08) was lower than that of the inactive group (0.71 卤0.09). The sensitivity, specificity and accuracy of the diagnosis of active sacroiliac arthritis in patients with axspa were 80.8, 74.5 and 78.7 respectively. Conclusion the abnormal blood flow around and inside the sacroiliac joint can be used to reflect the active sacroiliac arthritis in patients with axspa by Doppler ultrasound, and the accuracy is high.
【作者单位】：南昌大学第一附属医院超声科;
【分类号】：R445.1;R684

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