核素骨显像对骶髂关节、髋关节及脊柱关节病的诊断

Bone scintigraphic imaging of sacroiliac joint, hip joint and spondyloarthritis

目的 建立国人骶髂关节 软组织、骶髂关节 骶骨、髋关节 软组织、髋关节 股骨放射性比值的正常参考值 ,探讨其在脊柱关节病 (SpA)中的诊断价值。方法 对无腰腿症状、CT检查骶髂关节正常的不同年龄者 130例 2 6 0组关节分为 4组 :15～ 19岁 ,～ 2 4岁 ,～ 39岁 ,≥ 40岁 ,进行全身骨骼及骶髂关节、髋关节周围结构的SPECT显像 ,取得 4组不同部位放射性比值。同时对临床诊断为SpA的 45例患者进行骨显像 ,计算其左右骶髂关节 软组织、骶髂关节 骶骨放射性比值。结果 对以上 4组数据进行统计学处理 ,得出正常参考值范围。对 4组数据的变异系数进行分析 ,发现骶髂关节 骶骨放射性比值变异系数最小 ,可作为骶髂关节代谢状况判断标准。 45例SpA患者中未分化脊柱关节病 (uSpA) 2 3例 ,其骶髂关节 骶骨比值升高占 86 9% (2 0 2 3例 ) ;合并其他关节病变 2 1例。结论 骶髂关节

Objective To establish normal reference value of radioactivity ratio of sacroiliac joint /soft tissue,sacroiliac joint/sacrum, hip joint/soft tissue and hip joint/thighbone in Chinese, and discuss its diagnostic value in spondyloarthritis (SpA). Methods 260 joints from 130 normal individuals were divided into 4 groups according to ages: 15～19 years, ～24 years, ～39 years and ≥40 years. They have exhibited no waist leg symptom and a normal CT exam in sacroiliac joint. SPECT was performed on whole body skeleton as well as sacroiliac joint and hip joint to measure the radioactivity ratio in these joints respectively. In the same time, SPECT was also undertaken in 45 patients with SpA to calculate the radioactivity ratio of sacroiliac joint/soft tissue and sacroiliac joint/sacum. Results After statistical processing, a normal reference value of all radioactivity ratio in four groups was obtained. Analysis on the data in 4 groups showed that the variant coefficient of sacroiliac joint/sacrum is minimal, and thus to be used as a judgment for sacroiliac joint/sacrum osteometabolism. In 45 patients with SpA, 23 cases were undifferentiated spondyloarthritis. The radioactivity ratio of sacroiliac joint/sacrum increased in 20 cases (86.9%), while other joint disorders occurred in 21 cases. Conclusion The radioactivity ratio of sacroiliac joint/sacrum is of important value in early diagnosis for SpA.