摘要
目的:探讨CT扫描对强直性脊柱炎(ankylosingspondylitis,AS)的诊断价值以及病程与其骶髂关节病变分级的关系。方法:将解放军第四军医大学西京医院330例根据临床表现和实验检查确诊或疑诊,并符合Calin等1977提出的所谓“AS临床筛选标准”的AS患者作为研究对象,分别参照X射线及CT片对其进行分级和征象统计,并依其病程长短将患者分为4组,比较组间骶髂关节病变的分期情况。结果:所有X射线诊断为0~Ⅳ级骶髂关节病变的患者中,CT结果与X射线诊断一致的符合率分别为28.8%,36.2%,9.8%,75.2%和89.5%。其中,以Ⅲ,Ⅳ级分期两者的符合率最高,而X射线分级为0~Ⅱ的病例约71.2%,44.1%和34.3%在CT结果中可提高一两个诊断级别。在根据病程的分组中,病程在1年以下者,Ⅱ级以下骶髂关节病变约占总关节数的92.8%,Ⅲ,Ⅳ级病变仅为7.2%;1~2年者则分别为65.7%和34.3%;而3年以上者Ⅲ,Ⅳ级骶髂关节病变约占74.1%,而Ⅱ级以下病变仅为29.3%。结论:CT扫描对AS骶髂关节病变的诊断具有重要价值。CT与X射线平片的区别在于细微征象的显示率较高,对疑诊患者尽早行CT检查,可及时发现骶髂关节病变,是尽早治疗的关键。
AIM:To evaluate the diagnostic value of CT for ankylosing spondylitis(AS) and the relation between the course and the lesion classification of sacroiliac joint with CT.METHODS:All 330 patients were candidated, who were from Xijing Hospital of Fourth Military Medical University, with diagnosed or suspected AS by clinical and experimental tests, and coincidence to AS Clinical Screening Criterion suggested by Calin et al in 1977. Features of X ray and CT scan were classified and compared respectively. Meanwhile, patients were divided into four groups according to the course of AS, and the lesion of sacroiliac joint between these 4 groups was analyzed.RESULTS:Among all patients with sacroiliac joints in five degrees (0 to Ⅳ) diagnosed by X ray and CT,the coincidence ratios were 28.8%,36.2%, 9.8%,75.2%and 89.5%,respectively.Meanwhile, the results showed that there were higher coincidence ratios of X ray and CT in Ⅲand Ⅳdegrees, but there were 71.2%(0 degree),44.1%(Ⅰdegree) and 34.3%(Ⅱdegrees) diagnosed as 0 to Ⅱdegrees by X ray, which were raised to one or two degrees according to CT findings. The ratios of 0 toⅡdegrees in AS patients below 1 year, 1 to 2 years and above 3 years were 92.8%, 65.7%and 29.3%, and the ratios of Ⅲand Ⅳdegrees were 7.2%, 34.3%and 74.1%, respectively.CONCLUSION:Above all, CT scan is very useful for examining the sacroiliac joints in AS. The resolution power for small signs of CT is higher than that of X ray. Therefore, the suspected AS patients should be examinated by CT to make sure the lesion of sacroiliac joints early.
出处
《中国临床康复》
CSCD
2004年第30期6664-6665,共2页
Chinese Journal of Clinical Rehabilitation