强直性脊柱炎的影像学诊断

Imaging diagnosis of ankylosing spondylitis

目的:研究强直性脊柱炎所致骶髂关节改变的X线及CT表现,探讨其早期征像,比较X线与CT对AS诊断的价值。方法:临床确诊的50例强直性脊柱炎患者,摄取骶髂关节正侧位平片,其中30例患者做骶髂关节CT扫描,总结其影像学表现与病理分级及临床分期的关系,并对两种检查方法所示结果进行比较分析。结果:AS早期骶髂关节改变影像学表现为:骨质侵蚀、虫蚀样破坏,囊变、周围骨硬化等,对于病变征像,X线与CT显示基本相同,X线为首选方法,但是CT对细微结构显示清楚,能更直观的反映病变的范围及关节间隙的改变,对早期病变显示优于X线平片,对Ⅲ、Ⅳ级病变,如仅满足诊断要求,CT扫描并非必需,对需观察病变及评价疗效者,CT是一种理想的检查方法。结论:骶髂关节骨质侵蚀、破坏、囊变、骨质硬化是AS的早期征像,CT对病变细节显示更清楚对早期病变更具敏感性,对疗效观察更为有利。

Objective： To study the forepart imaging findings both in X-ray and CT of sacroiliac joint lesions induced by ankylosing spondylsitis（AS）, compare the value of the two examination methods in the diagnosis.Methods： Fifty AS patients were recruited, underwent X-ray plain film. Thirty of them do CT examinations, sum up the relations between the imaging and the grade of pathology and clinic. Results：The early features of sacroiliac joint lesions is erosion, cystic lesions of hone and cirrhosis around them. As to the images, CT can found more imperceptibly and intuitively which could not he found by X-ray, show the early features of AS better than X-ray for grade Ⅰ to Ⅱ , but to grade Ⅲ to Ⅳ, CT is not necessary if only for diagnesis, but for the needs of ohservation or evaluating about the curative effect, CT is a perfect examining methed. Conclusion：The early features of AS on sacroiliac joint are erosion, cystic lesions of hone and cirrhosis around them, CT scan dearly reveal the small constructions of the sacroiliac joint lesions and has more sensitivity on early patients and have more advantage on curative effect observed.