骶髂关节正位放射学分型及其临床意义

The types of the sacroiliac joint on the pelvic anteroposterior radiography and its clinical implications

目的探讨骨盆正位X线片上骶髂关节的放射学分型,以指导临床对骶髂关节的认知。方法对950例(男475,女475)正常骶髂关节的骨盆正位X线片进行观测。根据骶髂关节间隙的数量及间隙的走行特点,对骶髂关节进行放射学分型。结果正常骶髂关节的放射学分型大致可分为3种类型:1 I型为双侧单间隙型,男女分别为8.8%(42例)和25.7%(122例);2Ⅱ型为双侧双间隙型,男女分别为79.2%(376例)和46.7%(222例);3Ⅲ型为一侧单间隙,一侧双间隙型,男女分别为12%(57例)和27.6%(131例)。II型又分为四个亚型:1"2"型双间隙,男女分别为0.8%(3例)和6.6%(15例);2"12"型双间隙,男女分别为56.4%(212例)和69.8%(155例);3"21"型双间隙,男女分别为2.1%(8例)和1.8%(4例);4"121"型双间隙,男女分别为41.8%(157例)和19.8%(44例);III型也分为两个亚型:1左侧单间隙,右侧双间隙型的男女分别为26.3%(15例)和49.6%(65例);2左侧双间隙,右侧单间隙型的男女分别为73.7%(42例)和50.4%(66例)。结论正常人骶髂关节的放射学分型以双侧双间隙型最常见,其中又以"12"型双间隙所占构成比最大,但各型构成上有性别差异。

Objective To explore the radiological types of the sacroiliac joint on the anteroposterior radiography of the pelvis, providing guidance for the clinicians to know more about the sacroiliac joint. Methods 950 cases （male and female account for half respectively） of normal sacroiliac joints were observed on the anteroposterior radiography of the pelvisand then the radiological types of the sacroiliac joint were classified according to the number of the sacroiliac spaces and the characteristics of their shape. Result （1） The normal sacroiliac joints on the anteroposterior radiography of the pelvis can be classified to three types： ①8.8% of males （42 cases） and 25.7% of females （122 cases） were classified as type I, which was called single gap on both sides type; ②79.2% of males（376 cases） and 46.7% of females（222 cases） were classified as type II, which was called double gaps on both sides type;③12% of males（57 cases） and 27.6% of females（131 cases） were classified as type III, which was called one side single gap and the other side double gaps type;（2） Double gaps on both sides type can be particularly classified to four subtypes：①0.8% of males（3 cases） and 6.6% of females（15 cases） were classified as 2 double gaps type;②56.4% of males（212 cases） and 69.8% of females（155 cases） were classified as 12 double gaps type;③2.1% of males（8 cases） and 1.8% of females（4 cases） were classified as 21 double gaps type;④41.8% of males（157 cases） and 19.8% of females （44 cases） were classified as 121 double gaps type;（3） One side single gap and the other side double gaps type can also be classified to two subtypes： ①26.3% of males（15 cases） and 49.6% of females（65 cases） were classified as Single gap on left and double gaps on fight type; ②73.7% of males（42 cases） and 50.4% of females（66 cases） were classified as double gaps on left and single gap on right type. Conclusions （1） The most common type of the normal sacroiliac joints on the anteroposterior radiography of the pelvis is the double gaps on both sides type, in which the largest proportion of all four subtypes is the ＂12＂ double gaps type, but the constituent ratio of each type on gender has a significant variation.