改良髋关节磁共振成像扫描方法在发现骶髂关节病变中的应用价值

Application value for modified hip MRI scan in the sacroiliac joint

目的：通过对髋关节磁共振成像（MRI）冠状位扫描的改良，从而发现骶髂关节病变，弥补临床医生判断失误，提高疾病的检出率。方法对265例申请髋关节MRI检查的患者增加冠状位扫描层数，使每例患者双侧骶髂关节均能大部分显示。结果发现骶髂关节病变的共计20例，发现率为7．5％，年龄11-65岁，其中强直性脊柱炎16例，退行性骨关节炎2例，骶髂关节结核1例，外伤导致骨挫伤1例。结论骶髂关节病变，尤其是强直性脊柱炎是一种以危害年轻人为主的慢性炎性疾病，起病隐匿，临床部分患者以髋关节为主述症状，引起误诊，MRI在检查髋关节时适当在冠状位上增加扫描层数，能发现7．5％的遗漏病变，方法简便易行，值得推广。

Objective Through improvement of hip MRI coronal scan, the pathological changes can be found in the sacroiliac joints,which will do help clinicians for making right judgment, and improving disease detection. Methods Coronary scanning layer was added in MRI detection for 265 cases of hip patients , so that bilateral sacroili-ac joints of each patient could be mostly displayed. Results A total of 20 cases with sacroiliac joint diseas was found with the detection rate of 7.5%, who aged 11-65 years. There were 16 cases of ankylosing spondylitis, 2 cases of os-teoarthritis, one case of sacroiliac joint tuberculosis, and 1 case of bone contusion caused by trauma. Conclusion Sacroiliac joints, especially in ankylosing spondylitis is a chronic hazard inflammatory disease , which mainly occurred in young people, with insidious onset. Some patients with hip joints don′t have symptoms clinically, which may lead to misdiagnosis. But MRI with coronal scan layers when checking the hip, can find 7.5%of missed lesions, which is sim-ple, worthy of promotion.