髋关节受累的AS患者X线、CT及MRI检查结果分析

发布时间：2018-01-29 11:33

本文关键词： 强直性脊柱炎髋关节 X线平片计算机体层摄影磁共振成像　出处：《山东医药》2015年17期 　论文类型：期刊论文

【摘要】：目的分析髓关节受累的强直性脊柱炎(AS)患者X线、CT及MRI检查结果,以提高髓关节受累的AS诊断水平。方法对89例AS患者行骨盆X线平片和MRI检查,其中59例同时行髋关节CT检查。对X线平片、CT和MRI显示的AS髋关节受累结果进行分析。结果 89例患者178侧髋关节中,X线平片和MRI显示异常分别为30侧和125侧;X线平片改变包括间隙狭窄22侧、股骨头密度不均8侧、骨质破坏16侧、骨质硬化6侧、骨质增生6侧;85例173侧髋关节在MRI上存在急性炎症改变,MRI显示关节积液93侧、滑膜增厚7侧、滑膜强化13侧、骨髓水肿54侧、股骨头高信号影43侧、髋臼高信号影23侧、肌腱端炎1侧、骨质破坏14侧、间隙变窄9侧、脂肪沉积4侧。CT检查59例共118侧髋关节,显示异常为32侧,CT发现X线平片未能显示的17侧骨破坏和MRI未显示的26侧骨破坏。X线平片、CT、MRI显示髋关节异常率分别为13.6%(16/118)、27.1%(32/118)和69.5%(82/118),MRI显示髋关节受累的敏感度优于X线平片和CT(χ2分别为76.01、42.42,P均0.05)。结论在AS髋关节受累的影像学检查中,骨盆X线平片可作为AS筛查手段,在显示AS髋关节受累慢性骨结构改变方面,CT优于X线平片和MRI;在显示髋关节受累敏感度方面MRI优于X线平片和CT。
[Abstract]:Objective to analyze the results of X-ray CT and MRI in patients with ankylosing spondylitis. Methods Eighty-nine patients with as were examined by plain pelvic radiography and MRI, 59 of whom underwent CT examination of hip joint. Results the results of as hip involvement were analyzed by CT and MRI. Results the abnormal findings of plain film and MRI were 30 and 125 respectively in 178 hip joints of 89 patients. X-ray films included 22 sides of space stenosis, 8 sides of uneven density of femoral head, 16 sides of bone destruction, 6 sides of bone sclerosis and 6 sides of bone hyperplasia. 85 cases (173 sides) of hip joint showed acute inflammatory changes on MRI. MRI showed 93 sides of joint effusion, 7 sides of synovial thickening, 13 sides of synovial enhancement and 54 sides of bone marrow edema. 43 sides of femoral head hyperintense shadow, 23 sides of acetabular hyperintense shadow, 1 side of tendinitis, 14 sides of bone destruction, 9 sides of space narrowing, and 59 cases (118 sides) of hip joint examined by CT. The abnormal manifestations were 32 sides of CT scan and 26 sides of bone destruction which could not be displayed on X-ray plain film and 26 sides on MRI. MRI showed that the abnormal rate of hip joint was 13. 6% / 118 / 27.1 / 118) and 69. 5% / 82 / 118, respectively. The sensitivity of MRI in the diagnosis of hip involvement was better than that in plain radiography and CT (蠂 ~ 2 = 76.01) 42.42 (P < 0.05). Conclusion in the imaging examination of as hip involvement, the sensitivity is better than that of X-ray and CT (蠂 ~ 2 = 76.01, 42.42, P < 0.05). Pelvic X-ray plain film can be used as a screening method for as. Ct is superior to X-ray plain film and MRI in showing the chronic bone structure changes of as hip joint. MRI is superior to X-ray plain film and CTT in showing sensitivity of hip joint involvement.
【作者单位】：石河子大学医学院;新疆维吾尔自治区人民医院;新疆石河子大学医学院第一附属医院;
【基金】：国家自然科学基金项目(81160377)
【分类号】：R593.23;R445.2;R816.8
【正文快照】： 强直性脊柱炎(AS)是脊柱关节病的原型,以骶髂关节及脊柱的炎性病变为主要特点,外周关节常累及,并可伴发关节外表现,重者可发生关节畸形和强直[1]。髋关节是AS最易受累的外周关节[2]。研究[2,3]报道,AS髋关节受累率为19%~36%。晚期髋关节病变患者只能选择关节置换治疗[3],而髋

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