能量多普勒超声检查骶髂关节对早期强直性脊柱炎的诊断价值

The Diagnostic Value of Power Doppler Ultrasound Examination of the Sacroiliac Joint in the Early Ankylosing Spondylitis

目的：评价能量多普勒与核磁共振对比，在早期强直性脊柱炎（Ankylosing Spondylitis，AS）患者骶髂关节炎诊断的价值。方法2012年1~12月间，绵阳市中心医院门诊及住院的病程＜2年的强直性脊柱炎患者共50例，强直性脊柱炎诊断根据1984年修订的纽约标准。其中男44例，女6例，年龄15～42（25±4）岁，病程6～24（12±6）个月。每例患者都采用MRI检查骶髂关节病变，记录活动性骶髂关节炎共92个。对每位患者的两侧骶髂关节进行彩色多普勒检查，能量多普勒显示骶髂关节区域的血流信号，并测量血流阻力指数（resistance index，RI）。结果50例患者的100个骶髂关节显示有血流信号的87个，1级36例，2级51例，能量多普勒超声在其中81个骶髂关节血流信号中测得RI，RI为0．38～0．71，平均值0．48±0．16。χ2分析1显示，能量多普勒与MRI在检出骶髂关节病变方面差异不具有统计学意义（P=0.249）。分析能量多普勒发现的骶髂关节血流阻力指数与CRP、ESR、BASDI评分的关系发现，患者的炎症指标越高、BASDI评分越高，骶髂关节血流阻力指数越低。结论能量多普勒检查骶髂关节病变可作为诊断早期强直性脊柱炎的重要辅助检查，低阻血流是提示活动性强直性脊柱炎骶髂关节病变的重要线索。

Objective To evaluate the diagnostic value of power Doppler in early Ankylosing Spondylitis sacroiliitis contrast with nuclear magnetic resonance （MRI）. Methods 50 AS patients with course of disease less than 2 years were recruited in this study, and the diagnosis are ac-cording to New York criteria revised in 1984. Among these patients, 44 are male, 6 are female, ages between with 15 and 42, average 25±4, course of disease between with 6mo and 24 mo, average 12 ±6 mo. Every patients＇ two sacroiliac joints accepted examination by MRI and power Doppler. Recorde the number of active sacroiliitis, if blood flow signal can be showed by power Doppler, then measure blood resistance index （RI）. Results 87 sacroiliac joints showed blood flow signal, 36 were Grade 1,and 51were Grade 2, among these sacroiliac joints, 81 were measured RI, which number betweens with 0.38~0.71, average 0.48±0.16. χ2 analysis shows no significance dif-ference between MRI and power Doppler in detection of sacroiliitis. This study find out that the higher CRP、ESR and BASDI scores, the lower RI. Conclusion Power Doppler can be used as a very important assistant examination in early AS,low blood resistance index prompts active sacroiliitis.