幼年强直性脊柱炎骶髂关节病变的CT诊断

CT diagnosis of sacroiliac joint in juvenile ankylosing spondylitis

目的总结幼年强直性脊柱炎患者骶髂关节的CT影像特征，探讨CT对该病的诊断价值。方法搜集43例强直性脊柱炎患儿，年龄8～18岁，病程3个月～7年，所有病例均行骶髂关节CT检查。结果骶髂关节面的主要改变为：髂骨面的改变包括关节面的槌糊、不规则，骨皮质的不连续、变薄、增厚；关节面下囊变，骨破坏和骨硬化。骶髂关节间隙的CT表现为正常、增宽及狭窄，未见强直征象。骶骨面的改变明显较髂骨面少。按国际标准分级，本组病例为0～Ⅲ级：结论幼年强直性脊柱炎骶髂关节病变具有一定特征性，病变程度与病程有关。CT对该病具有较高的诊断价值。

Objective To summarize the CT features of sacroiliac joint in juvenility with ankylosing spondylitis, Methods CT scanning of sacroiliac joint was performed in 43 children （aged 8 - 18） with ankylosing spondylitis. Results On CT scaning,the articular surface of sacroiliac joint became indistinct,irregular with discontinued. thinned or thickened cortex. Subchondral cystic degeneration,bony destruction and sclerosis were seen. The width of the sacroiliac joint space showed normal ,widened or narrow. The above changes were less severe on sacral side than on iliac side. According to the international grading,the patieuts in this group belonged to grade 0～Ⅲ. Conclusion The CT features of sacroiliac joint in juvenility with ankylosing spondylitis are typical ,and the degree of lesion is related to the course of the disease. CT scaning is a valuable technique to diagnose this disease.