骶髂关节MRI检查在强直性脊柱炎诊断中的价值

Clinical value of the sacroiliac joint MRI inspection in the ankylosing spondylitis

目的探讨强直性脊柱炎（AS）早期骶髂关节MRI表现及对诊断的价值。方法对23例患者行骨盆X平片及双侧骶髂关节MR扫描,对比分析X线、MRI扫描征象。结果23例AS患者中X线检出率52.2%,MRI检出率87.0%。Ⅰ-Ⅱ级患者MRI可见关节软骨增厚、信号异常,滑膜信号异常,以及骨髓水肿;Ⅲ-Ⅳ级患者除有Ⅰ-Ⅱ级的表现之外,还可见大范围的骨质硬化、骨髓内脂肪沉积。Ⅰ-Ⅱ级病变MRI检出率高于X线,差异有统计学意义（P〈0.05）,对Ⅲ、Ⅳ级病变两种方法检出率相似（P〉0.05）。结论MRI能够显示AS患者骶髂关节的早期病理改变,可作为AS早期诊断的首选方法。

Objective To explore the early MRI image of the sacroiliac joint in the ankylesing spondylitis. Methods Pelvic X-ray examination and bilateral sacroiliac joint MR scanning were perform on twenty-three patients,the results of X-ray examination and MR seanning was analyzed. Results X-ray detection rate was 52. 2% and MRI was 87. 0%;MRI signs of articular cartilage thickening and its signal abnormalities,synovial signal abnormalities, and bone marrow edema among G Ⅰ-Ⅱ patients were clear. The large-scale bone sderesis and bone marrow fat deposition among G Ⅲ-Ⅳ patients, besides the symptoras among G Ⅰ-Ⅱ patients. MRI detection rate for G Ⅰ-Ⅱ patients was significantly higher than that of X-ray （P 〈0.05）,no significance was found in the detection G Ⅲ-Ⅳ patients with two methods （P 〉0.05）. Conclusion Mill may present the early pathological changes of the sacroiliac joint in the ankylosing spondylitis, and can be used as the preferred choice of the AS early diagnosis