育龄女性未分化脊柱关节病患者骶髂关节的CT影像特点

CT imaging features of sacroiliac joint in u Sp A female patients of child-bearing age

目的探讨育龄女性u Sp A患者骶髂关节影像学特征。方法对60名育龄女性u Sp A患者行骶髂关节CT检查,测量骶髂关节间隙宽度及骶髂骨皮质厚度,观察骶髂关节间隙清晰程度、骶髂骨皮质边缘光滑程度及皮质下骨质密度情况。结果 53%u Sp A女性病例骶髂关节关节间隙模糊。关节间隙小于2 mm的占65.8%。95%表现为单侧或双侧关节面模糊、骶髂骨面皮质边缘毛糙、软骨下骨质密度不均和软骨下微小囊变等,其中20%关节面分级为3级,u Sp A女性病例骶髂骨皮质厚度随年龄增长逐渐增厚,关节面骨质破坏及皮质增厚以髂骨侧为著。36.6%u Sp A女性病例骶髂关节关节腔内可见线条样点状气体样低密度影。结论育龄女性u Sp A患者骶髂关节间隙模糊、消失、骶髂关节间隙变窄、关节面骨质破坏及分级、关节面下骨质硬化及骶髂关节真空现象的发生率和程度均较正常育龄女性明显增高,骨质破坏在关节髂骨侧更严重。对骶髂关节有异常表现的无症状育龄女性或有临床症状但CT分级为0级或1级的育龄女性,需要根据临床、实验室检查与MR检查进一步确定。

Objective To investigate CT imaging features of sacroiliac joint in u Sp A female patients of child- bearing age. Methods The sacroiliac joint CT of 60 u Sp A female patients of child- bearing age was analyzed. The width of sacroiliac joint space and the thickness of sacroiliac cortex were measured, the clearness of sacroiliac joint space, the smooth of sacroiliac cortex edge and the bone density under the cortex were observed. Result The sacroiliac joint spaces were blurred in 53% u Sp A female patients of childbearing age. The width of sacroiliac joint space of u Sp A female patients of child-bearing age was less than 2mm in 68.5% of the cases. It was fuzzy on the surface of unilateral or bilateral joint, rough on the edge of sacroiliac cortex, uneven in densities of cartilage in 95% u Sp A female patients of child- bearing age, 20%articular surfaces were classified as graded 3. The sacroiliac cortex became thicker with age. The erosions of the articular surface and the cortex thickened changes were more severe in the iliac side. 36.6% of the articular cavity in the normal child- bearing age women had linear, dotted and gasiform low density shadow.Conclusion The incidence and extent of sacroiliac joint spaces blurring, narrowing of the joint space,erosion of articular surface and grade, and bone proliferation under surface are higher in u Sp A female patients of childbearing age than that in normal child- bearing age women. The incidence of sacroiliac joint vacuum phenomenon is higher in u Sp A female patients and is related to u Sp A. For normal women of child-bearing age with abnormal sacroiliac joint changes, they should be determined whether the arthritis exists based on history,laboratory tests and MR. For normal women of child-bearing age with symptoms but being by graded CT as 0or 1, MR should be further undertaken to visualize early active inflammation.