彩色多普勒超声骶髂关节检查在早期强直性脊柱炎诊断中的应用价值

The application of color Doppler ultrasound of sacroiliac joint in diagnosing early ankylosing spondylitis

目的探讨骶髂关节彩色多普勒超声检查在早期强直性脊柱炎(AS)患者诊断中的应用价值。方法56例已确诊的早期AS患者为病例组(112个骶髂关节),同时选择51例健康体检者为健康对照组(102个骶髂关节),分别进行彩色多普勒超声检查,对比分析骶髂关节区域血流信号、分级、血流频谱的分类及分布、血流的显示率、动脉血流阻力指数(★)等。结果病例组骶髂关节区域的血流信号明显多于健康对照组(x^2=105.737,P=0.000);病例组以2~3级为主,健康对照组以0~1级为主;病例组总血流显示率为91.1%,高于健康对照组的35.3%(P<0.01),病例组动、静脉血流显示率分别为80.4%、68.8%,高于健康对照组的32.4%、13.7%(P均<0.01);病例组舒张期正向低阻血流阳性率为74.1%,高于健康对照组1.0%(P<0.01),而高阻血流、反相血流阳性率分别为1.8%、4.5%,低于健康对照组的12.7%、18.6%(P<0.01);病例组动脉平均RI为(0.56±0.09),低于健康对照组的(0.89±0.10)(t=-12.787,P=0.000)。结论AS患者骶髂关节低阻动脉血流及静脉血流信号都明显增多,彩色多普勒超声有助于其早期诊断。

Objective To investigate the diagnostic value of color Doppler ultrasound examination in sacroiliac joint early ankylosing spondylitis （AS）. Methods 56 patients who had been diagnosed of early AS patients as case group （ 112 sacroiliac joints）, and 51 healthy subjects were enrolled as healthy control group （102 sacroiliac joints, respectively）, they were exam by color Doppler uhrasonography, sacroiliac joint, classification, regional blood flow signal classification and distri- bution of blood flow, blood flow display rate, arterial resistance index （RI） were compared between the two groups. Results Blood flow signal of cases groupg＇s sacroiliac joint region were more obvious than the healthy control group （ X2 = 105. 737, P = 0.000） ; case group mainly with degree of 2 to 3, healthy control group with degree from 0 to 1 ; the case group total flow rate was 9l. 1%, higher than that in the healthy control group of 35.3% （ P 〈 0.01 ）, case groupg artery and venous blood flow display rate were 80.4% and 68.8%, higher than that in healthy control group of 32.4% and 13.7% （ P 〈 0.01 ） ; the posi- tive rate of diastolic forward low resistance flow in case group was 74.1%, higher than that of the control group with 1.0% （P 〈 0.01 ）, and positive rate of reverse flow and high resistance flow were 1.8%, 4.5%, respectively in the case group, lower than that in healthy control group with 12~ 7% and 18.6% （ P 〈0.01 ） ; case group＇s artery mean RI was （0.56 ±0.09）, lower thanthat ofthe controlgroup （0.89±0.10） （ t = -12.787,P =0.000）.Conclusion AS patients with sac- roiliac joint revealed increase of low resistance arterial and venous blood flow signals, color Doppler ultrasonography is helpful in the early diagnosis.