X线平片和螺旋CT对强直性脊柱炎骶髂关节病变的诊断价值比较

The Comparison of Diagnostic Value of X-ray and Spiral CT for Sacroiliac Joint in Ankylosing Spondylitis

目的：研究X线平片和螺旋CT分别诊断强直性脊柱炎骶髂关节病变的效果。方法：选择2011年3月-2014年3月笔者所在医院收治的45例强直性脊柱炎骶髂关节病变的患者。分别对患者进行X线和螺旋CT两种影像学检查。检查后,记录分析两种检查手段对骶髂关节病变的诊断分级情况,并比较分析两种检查手段对骶髂关节病变各类征象的检出率。结果：螺旋CT对0～Ⅱ级骶髂关节病变（早期病变）的诊断效果明显优于X线,X线对Ⅲ～Ⅳ级患者的诊断与螺旋CT偏差较小。X线对关节面模糊的检出率（30.00%）明显高于螺旋CT（15.56%）,两种检出率比较差异有统计学意义（χ^2=7.6610,P=0.0056）;螺旋CT对关节软骨及骨侵蚀的检出率（66.67%）明显高于X线（51.11%）,两种检出率比较差异有统计学意义（χ^2=4.4977,P=0.0339）。结论：螺旋CT对早期强直性脊柱炎骶髂关节病变的诊断效果优于X线,X线和螺旋CT对中晚期强直性脊柱炎骶髂关节病变诊断的敏感性相同。

Objective：To study the diagnosis effect of X-ray and spiral CT for sacroiliac joint in ankylosing spondylitis.Method：45 cases with sacroiliac joint in ankylosing spondylitis from March 2011 to March 2014 in our hospital were studied.All the patients were examined with X-ray and spiral CT.After checking,the diagnostic hierarchical situation of the two methods were recorded and analyzed and sacroiliac joint detection rate of all types of signs were compared.Result：The diagnostic effect of spiral CT 0-Ⅱ grade sacroiliac joint（early lesions） was better than X-ray,the deviation of X-ray and spiral CT for patients with stage Ⅲ-Ⅳ diagnosis was small.X-ray of the articular surface of the fuzzy detection rate（30.00%） was significantly higher than that of spiral CT（15.56%）,there was significant difference（ χ^2=7.6610,P=0.0056）,spiral CT of articular cartilage and bone erosion detection rate（66.67%） was significantly higher than that of X-ray（51.11%）,two check were significantly different（ χ^2=4.4977,P=0.0339）.Conclusion：Spiral CT in early ankylosing spondylitis sacroiliac joint is better than X-ray diagnosis,and the sensitivity of X-ray and spiral CT in advanced ankylosing spondylitis sacroiliac joint disease diagnosis are the same.