CT和磁共振成像对脊柱关节病早期诊断的价值

The early diagnostic value of CT and MRI for spinal joint disease

目的：探讨脊柱关节病（sponyloarthropathies，SPA）的CT和磁共振成像（MRI）表现，以提高SPA的早期诊断。方法对16例SPA的病例进行10例CT横状位、16例MRI行横、矢状位扫描，T2WI，T1WI，STIR，分析其骨质、形态及信号改变。结果 SPA的CT和MRI表现为脊柱炎、椎间盘炎、脊柱关节炎和韧带附着炎。16例SPA 43个椎体中，其中侵犯T6、T7、L5、S1各1个，T8、T9、L4各2个，T10、L2、L3各3个，L1为6个，T11为8个，T12为11个。以T11~L1侵犯增多，共占58％（25/43）。单纯椎体受累13个，占30％（13/43）。椎体和附件受累30个，占70％（30/43）。结论 CT、MRI二者结合有利于SPA的早期诊断，特别是MRI下骶髂关节、脊柱椎小关节滑膜等处骨质结构改变、骨髓水肿、滑膜炎、关节软骨侵袭、韧带起止炎等MRI表现，这对临床早期诊断、治疗及愈合等均有十分重要临床价值。

Objective To discuss the computed tomography （CT） and magnetic resonance imaging （MRI） mani-festation of spinal joint disease （sponyloarthropathies, SPA）, in order to improve the early diagnosis of SPA. Methods Of 16 cases with SPA, 10 cases underwent CT transverse position scanning, while 16 cases for MRI transverse, sagit-tal and coronal scanning, T1WI, T2WI, STIR,,then analyze its bone, morphology and signal change. Results The CT and MRI manifestation of SPA showed as spondylitis, intervertebral disc disease, arthritis and spine ligament attach-ment. There were 43 vertebral bodies in 16 cases of SPA, including infringement of T6 for 1, T7 for 1, L5 for 1, S1 for 1, T8 for 2 T9 for 2, L4 for 2, T10 for 3, L2 for 3, L3 for 3, L1 for 6, T11 for 8, and T12 for 11. T11-L1 invasion increased, accouting for 58% （25/43）. Pure vertebral was involved in 13 cases , accouting for 30% （13/43）. Vertebral body and attachments were involved in 30 cases, accounting for 70% （30/43）. Conclusion The combination of CT, MRI is helpful for the early diagnosis of SPA, especially MRI manifestation for sacroiliac joints, spine vertebra small joint synovial place such as changes in bone structure, bone marrow edema, synovitis, articular cartilage invasion, ligament start-stop inflammation have important clinical value for the early clinical diagnosis, treatment and etc.