MSCT在强直性脊柱炎骶髂关节病变分级中的诊断价值

The Diagnostic and Staging Value of MSCT in Sacroiliac Joint Disease of Ankylosing Spondylitis

目的探讨MSCT在强直性脊柱炎骶髂关节病变分级中的诊断价值。方法收集本院经临床确诊为AS SIJ病变且均行DR及MSCT检查的患者198例,分析双侧SIJ的6种征象,比较DR与MSCT在诊断及分级中的差异。结果 DR及MSCT 6种征象出现频率分别为:关节面模糊(180,201),关节面硬化(181,200),关节面下囊状、鼠咬状骨质破坏(176,205),关节间隙狭窄(183,183),关节间隙增宽(186,190),关节强直(186,190;诊断符合率分别为Ⅰ级44.7%,Ⅱ级55.7%,Ⅲ级58.8%,Ⅳ级62.5%)。结论 MSCT较DR能发现更多AS SIJ病变的细微改变,对Ⅰ、Ⅱ期的诊断优于DR,可提高本病分级诊断的准确率。

Objective To study the diagnostic and staging value of MSCT in sacroiliac joint （ SIJ） disease of ankylosing spondyli-tis （ AS） . Methods 198 patients with clinically confirmed AS sacroiliitis were chosen to be examined by DR and CT, then six signs of the bilateral SIJ were evaluated to compare the differences between DR and CT in diagnosis and staging. Results The frequency of 6 signs in DR and MSCT were blurred articular surface （180, 201）, articular facet sclerosis （181, 200）, articular surface destruc-tion （176, 205）, joint space stenosis （183, 183）, joint space widening （186, 190） and ankylosis （186, 190）;the diagnostic co-incidence rate was gradeⅠ44. 7%, Ⅱ55. 7%, Ⅲ58. 8%, Ⅳ62. 5% separately） . Conclusion MSCT can be used to detect more subtle changes than DR in AS SIJ, and it is better in classification diagnosis, especially in gradeⅠand Ⅱ.