强直性脊柱炎所致活动性附着点炎的MRI分析

MRI study of active enthesopathy in ankylosing spondylitis

目的:探讨强直性脊柱炎(AS)所致活动性附着点炎的MRI影像表现及价值。方法:对临床确诊的16例AS所致活动性附着点炎患者的临床及MRI资料进行回顾性分析,总结脊柱、骨盆、髋关节等处活动性附着点炎的MRI特征。结果:16例AS患者均有不同程度活动性附着点炎,主要表现为肌腱、韧带与骨附着部的骨髓及其周围软组织水肿,呈片状长T1长T2异常信号,边缘模糊,以脊柱骨突、棘突及股骨大转子、坐骨结节等部位为最常见。MRI活动性附着点炎的数量与患者的C-反应蛋白(CRP)(r=0.539,P=0.000)水平及Bath AS疾病活动指数(BASDAI)(r=0.475,P=0.008)呈正相关。结论:AS所致活动性附着点炎MRI表现较具特征性。MRI是显示该病最有效的方法,可用于AS疾病活动性的评价,也可用于早期诊断和疗效观察。

Objective：To study the MR imaging features and its diagnostic value in active enthesopathy of ankylosing spondylitis （AS）. Methods：The clinical data and MR images of 16 cases with active enthesopathy of AS were retrospectively analyzed. The MRI characteristics of active enthesopathy in spine, pelvis and hips were studied. Results：Of the 16 cases had different degrees of active enthesopathy,the main MRI findings were bone marrow and the surrounding soft tissue edema at the enthesis of muscle tendon,ligament and bone,manifested as patchy long T1 and long T2 signal intensities with blurred margin,mostly showed at the spinose and osseous processus of spine,major trochanter of femur and ischial tuberosity. The number of active enthesopathy showed on MRI was positively correlated with the level of C reactive portien （CRP, r= 0. 539 ,P=0. 000） and Bath AS disease activity index （BASDAI,r=0. 475 ,P=0. 008）. Conclusion：Characteristic MRI per formances of active enthesopathy in AS could be revealed. MRI is an effective imaging modality to show the lesion, which can be used for the evaluation of disease activity in AS, and can also be used for early diagnosis and curative effect observation.