强直性脊椎炎的影像学分析

Imaging Analysis of Ankylosing Spondylitis

目的:分析强直性脊椎炎(AS)骶髂关节受累的X线平片、CT和MRI的影像学特点,进一步提高诊断水平。方法:回顾分析48例AS患者的骶髂关节的X线、CT及MRI影像学表现特点。结果:X线检查23例,骶髂关节受累检出率17.4%;CT检查32例,骶髂关节受累检出率59.4%;MRI检查40例,骶髂关节受累检出率90.0%。MRI显示AS骶髂关节受累的检出率优于X线平片和CT(P<0.05)。结论:X线平片对典型AS能作出准确诊断,但对AS的早期诊断不如CT、MRI;MRI能显示X线平片和CT不能显示的AS骶髂关节受累的急性炎症改变,滑膜炎所致的少量积液和滑膜异常强化是骶髂关节受累最常见的MRI表现。

Objective：To analyze the imaging findings of the X-ray plain film, CT and MRI of ankylosing spondylitis（ AS） sacroiliac joint involvement, further improve the diagnostic level.Method：The imaging findings of 48 patients’ sacroiliac joint with AS were retrospective analyzed, including X-ray plain film, CT and MRI.Result：23 patients were detected by X-ray, sacroiliac joint involvement detection rate was 17.4%; 32 patients were detected with CT, sacroiliac joint involvement detection rate was 59.4%; 40 patients were detected by MRI, sacroiliac joint involvement detection rate was 90.0%. MRI showed the AS rate of sacroiliac joint involvement was superior to X-ray plain film and CT （P〈0.05）.Conclusion：X-ray plain film of typical AS can make accurate diagnosis, but for the early diagnosis of the AS MRI, CT. MRI can show the X-ray plain film and CT which not display the AS sacroiliac joint involvement of acute inflammatory change, synovial inflammation caused by a small amount of effusion and synovial abnormal enhancement is the most common sacroiliac joint involvement MRI manifestations.