强直性骶髂关节炎128层螺旋CT低剂量扫描与MRI影像对照研究

Comparative study of low dose 128-slice spiral CT and MR imaging in diagnosing ankylosing sac-roiliitis

目的评估128层螺旋CT低剂量扫描与1．5MRI显示强直性骶髂关节炎的影像学价值。方法搜集2010年7月至2012年8月60例骶髂关节炎患者，均在就诊2周内完成CT及MRI检查。采用Siemens128层螺旋CT机，CAREDose4D模式的MAS，根据不同受检者通过扫描定位图像自动调整，横断面及冠状面重建。Siemens1．5TMRI行轴位和冠状位扫描。分别评估骶髂关节炎的CT及MRI分级，各分级之间差异采用X^2检验。结果MRI检出0级病变8例；0级和Ⅰ级病变MRI显示明显优于128层螺旋CT（P〈0．05）；Ⅱ～Ⅳ级病变MRI和螺旋CT影像学分级比较差异无统计学意义（P〉0．05）；MRI可在X线未能明确显示骨结构改变前发现骨髓水肿、滑膜炎等急性炎性改变。结论MRI显示骶髂关节炎O级、Ⅰ级病变明显优于CT；Ⅱ～Ⅳ级病变MRI和螺旋CT显示差异无统计学意义，螺旋CT显示骨质硬化优于MRI，MRI有利于发现骨髓水肿、脂肪沉积、韧带附着点炎等早期病变，骶髂关节炎早期诊断首选MRI检查。

Objective To evaluate the image value of 128-slice spiral CT low dose scanning and 1.5 MRI shows the ankylosing sacroiliitis. Methods Sixty cases of sacroiliac arthritis patients from July 2010 to August 2012 in our hospital examined CT and MRI in admission of 2 weeks, use siemens 128-slice spiral CT machine, CARE Dose 4D scan, automatically adjust according to the different subjects by scanning the position image, cross-sectional and coronal reconstruction. The cases were graded and the chi-square test was analyze by SPSS 17.0. Results MRI detected grade 0 lesions in 8 cases. MRI was more sensitive than 128-slice spiral CT for lesions grade Ⅰ - Ⅱ （P 〈0. 05）. The difference of MRI and spiral CT image classification was not statistically significant among grade Ⅱ - Ⅳ （P 〉 0. 05 ）. Conclu-ions MRI showed the sacroiliitis grade 0 - Ⅰ lesions significantly better than CT; Grade Ⅱ - Ⅳ le-sions MRI and spiral CT show no difference, spiral CT show bone sclerosis superior to MRI. MRI is con-ducive to the discovery of bone marrow edema, fat deposition, ligament attachment points go far early le-sions. MRI examination is a preferred choice for the early diagnosis of sacroiliitis.