X线、CT和MRI在早期强直性脊柱炎骶髂关节病变诊断中的应用

Application Value of X-ray, CT and MRI in the Diagnosis of Ankylosing Spondylitis and the Sacral Iliac Joint Disease in Early Stage

目的探析早期强直性脊柱炎骶髂关节病变进行MRI、CT、X线检查诊断的临床应用价值。方法入选该院2013年9月—2015年6月早期强直性脊柱炎骶髂关节病变病人50例,分别进行MRI、CT、X线检查,比较3种检查方式的诊断准确性。结果早期强直性脊柱炎骶髂关节病变的MRI检查的诊断准确率94.0%显著高于X线检查的44.0%,差异有统计学意义（χ^2=29.22,P〈0.01）,CT检查诊断准确率92.0%显著高于X线检查的44.0%,差异有统计学意义（χ^2=26.47,P1〈0.01）;CT检查与MRI检查的诊断准确性差异无统计学意义（χ^2=0.15,P3=0.70）;早期强直性脊柱炎骶髂关节病变的CT检查囊性变或侵蚀、骨质硬化、毛刺感、欠光滑等影像特征显著高于X线检查,差异有统计学意义（P〈0.05）;早期强直性脊柱炎骶髂关节病变的MRI特征主要为关节韧带、软骨与滑骨的强化,骨髓水肿,关节软骨破坏。结论早期强直性脊柱炎骶髂关节病变进行MRI检查准确性较高,值得临床推广。

Objective To study the clinical application value of MRI, CT and X-ray in diagnosis of ankylosing spondylitis and the sacral iliac joint disease in early stage. Methods 50 cases of patients with ankylosing spondylitis and the sacral iliac joint disease in early stage treated in our hospital from September 2013 to June 2015 were given MRI, CT and X-ray examination, the diagnostic accuracy of the three examination methods was compared. Results The diagnostic accuracy rate of MRI examination in patients with ankylosing spondylitis and the sacral iliac joint disease in early stage was obviously higher than that of X-ray examination（94.0% vs 44.0%）, the difference was statistically significant（χ~2=29.22,P〈0.01）, the diagnostic accuracy rate of CT examination was obviously higher than that of X-ray examination（92.0% vs 44.0%）, the difference was statistically significant（χ~2=26.47,P1〈0.01）, the difference in the diagnostic accuracy between CT examination and MRI examination was not statistically significant（χ~2=0.15,P3=0.70）, the image features of cystic changes or erosion, osteosclerosis, burr sense and less smooth in patients with ankylosing spondylitis and the sacral iliac joint disease in early stage by CT examination were higher than those by X-ray examination, the difference was statistically significant（P〈0.05）,the MRI features of ankylosing spondylitis and the sacral iliac joint disease in early stage were mainly the strengthening of articular ligament, cartilage and bone, bone marrow edema and articular cartilage damage. Conclusion MRI in the examination of ankylosing spondylitis and the sacral iliac joint disease in early stage has high accuracy and it is worth promoting in clinic.