早期强直性脊柱炎骶髂关节病变的X线、CT和MRI比较

Analysis of X-ray,CT and MRI images for sacroiliac joint pathological changes of ankylosing spondylitis

目的探讨早期强直性脊柱炎骶髂关节病变的X线、CT和MRI影像中的表现特点及其临床意义。方法对于2009年10月～2011年6月在笔者所在医院进行治疗的42例早期强直性脊柱炎患者,分别应用X线、CT和MRI对患者的骶髂关节病变进行比较。结果 42例强直性脊柱炎患者共有84个骶髂关节病变,其X线及CT表现为:有13个0级,有15个Ⅰ级,有46个Ⅱ级,有6个Ⅲ级,有4个Ⅳ级。其中有11例患者的22个骶髂关节出现软骨异常表现,主要在T1WI和T2WI上出现无规则增粗或扭曲样中等信号,而正常线形中等信号的软骨影像消失。结论骶髂关节X线仍然是对于强直性脊柱炎患者的简单可靠的方法,但是定性分析较CT及MRI差,CT和MRI对于骶髂关节病变诊断基本一致,但MRI对于软骨破坏及韧带损伤方面的诊断优于CT。

Objective To discuss the different imagea characteristics of sacroiliac joint sacroiliac joint pathological changes in X-ray,CT and MR1 and explore the clinical cignificane. Methods Selecting 42 cases of AS patients who were examined in the author＇s hospital from October 2009 to June 2011,all of them were taken X-ray,CT and MRI. Results Among the 42 patients there had 84 sacroiliac joint lesions,the features of their X ray and CT：there were 13 cases of level 0,15 cases of level I ,46 cases of level II ,6 cases of level III ,4 cases of level IV ,11 patients had 22 sacroiliac joints with cartilage abnormalities among them which mainly manifest on the appearance of irregular thickening or distorted intermediate signal on T1WI and T2WI and the disappearing of the normal linear intermediate singal cartilage images. Conclusion The X-ray of the the sacroiliac joint is still a simple and reliable method for patients with ankylosing spondylitis, but its qualitative analysis is bad compared to CT and MRI.The CT and MRI for the diagnosis of sacroiliac joint is basically the same,but MRI is superior to CT in the diagnosis of the cartilage destruction and ligament damage.