CT和MRI在早期强直性脊柱炎骶髂关节病变中的诊断价值

发布时间：2018-10-15 18:13

【摘要】：目的探讨CT和MRI在早期强直性脊柱炎骶髂关节病变诊断中的应用价值。方法对接受诊治的强直性脊柱炎患者分别采用CT和MRI进行检查,比较两种检查方法的诊断效果。结果 MRI在强直性脊柱炎骶髂关节病变分级诊断中对0级和I级病变患者的诊断率明显高于CT检查,且差异具有统计学意义。而两种检查方法在其他级别的强直性脊柱炎骶髂关节病变分级诊断率比较则无明显差异。MRI检查对关节面下骨质囊变、腰5骶1关节突病变及骨髓水肿的检出率明显高于CT检查,且差异具有统计学意义。而CT检查在关节侵蚀和关节面增生硬化检出率方面明显高于MRI检查,且差异具有统计学意义。两种检查方法对关节间隙狭窄或增宽的检出率无明显差异。结论 MRI检查方法敏感,无放射性,CT检查强直性脊柱炎骶骼关节病变具有更高的空间分辨率,对关节侵蚀和关节面增生硬化等早期症状的检出率高于MRI,所以MRI检查应作为AS早期诊断的优选检查方法,但对一些显示不清楚的病情变化,要结合CT扫描来确诊。
[Abstract]:Objective to evaluate the value of CT and MRI in the diagnosis of sacroiliac joint lesions in ankylosing spondylitis. Methods the patients with ankylosing spondylitis were examined by CT and MRI respectively. Results the diagnostic rate of MRI in the classification of sacroiliac joint lesions in ankylosing spondylitis was significantly higher than that in CT, and the difference was statistically significant. However, there was no significant difference between the two methods in the diagnosis rate of sacroiliac joint lesions in other grades of ankylosing spondylitis. The detection rate of subarticular bone cysts, lumbar 5 sacral process lesions and bone marrow edema by MRI was significantly higher than that of CT. The difference was statistically significant. The detection rate of joint erosion and hyperplastic sclerosis in CT was significantly higher than that in MRI, and the difference was statistically significant. There was no significant difference between the two methods in detecting narrowing or widening of joint space. Conclusion MRI is sensitive and nonradioactive, and CT has higher spatial resolution in detecting sacroiliac joint lesions in ankylosing spondylitis. The detection rate of early symptoms such as joint erosion and hyperplastic sclerosis of articular surface was higher than that of MRI,. Therefore, MRI should be used as an excellent method for the early diagnosis of AS, but for some unclear changes of the disease, the diagnosis should be confirmed by combining CT scan.
【作者单位】：广东省深圳市龙华新区人民医院放射科;
【分类号】：R593.23;R816.8;R445.2

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