CT扫描对强直性脊柱炎骶髂关节病变的诊断价值

Diagnostic value of CT in sacroiliac joint with ankylosing spondylitis

目的 分析强直性脊柱炎骶髂关节CT表现，评价CT对其的诊断价值。方法 对32例临床诊断为强直性脊柱炎的骶髂关节CT征象，进行分级，并与临床分期对照。结果 临床早期CTⅠ～Ⅱ级表现骶髂关节面毛糙，皮质白线消失，骨关节面皮质中断，关节面下小囊变。临床中期即进展期CT Ⅲ级表现为骶髂关节面呈锯齿或毛刷状改变，关节面下小囊状骨质破坏及其周围增生硬化，关节间隙假性增宽或不规则狭窄，关节间隙内含气征。临床晚期即稳定期CT Ⅳ／级，可见韧带钙化，关节骨性强直和关节间隙消失。结论 CT能够清晰显示骶髂关节细微结构，作出正确分级诊断。

Objective To analyze the manifestation of SIJ with AS and evaluate the value of CT in the diagnosis. Methods CT findings of 32 cases with AS proved clinically were analyzed and graded,then compared with the clinical staging. Results In early stage, the manifestation showed vague articular face, interrupted joint cortex and subcortical microcysts （CT Ⅰ ～ Ⅱ grades）. In the intermediate stage （CT Ⅲ stage）,serrated or brush-like joint face,subcortical cystic destruction and irregularly harrowed joint space or even vaccumization were found. In the advanced stage （CT Ⅳ stage）,calcification of ligament, bony ankylosis of the joint with obliteration of joint space and osteoporosis or osteosclerosis were the findings. Conclusion CT scanning could clearly describe subtle changes of the structure of SIJ with AS. It is benefical to make correct grading.