CT和磁共振成像在早期强直性脊柱炎骶髂关节病变中的临床诊断效果分析

Clinical analysis of CT and MRI in sacroiliac joint disease of early ankylosing

目的观察CT和磁共振成像(MRI)在早期强制性脊柱炎骶髂关节病变中的临床诊断效果。方法收集早期强制性脊柱炎骶髂关节病变患者68例,患者入院后均先行CT检查,后行MRI检查,将2种影像结果与手术结果比较,比较CT和MRI在早期强制性脊柱炎骶髂关节病变中的临床诊断效果。结果 MRI和CT检查Ⅱ级、Ⅲ级及Ⅳ级早期脊柱炎骶髂关节病变率差异无统计学意义(P>0.05);MRI检查0级、Ⅲ级早期脊柱炎骶髂关节病变率,低于CT(P<0.05);MR检查Ⅰ级早期脊柱炎骶髂关节病变率,高于CT(P<0.05);2种检查方法下关节间隙变化差异无统计学意义(P>0.05);MRI检查关节面下骨质囊变、腰5骶1关节病变及骨髓水肿率,高于CT(P<0.05);MRI关节侵蚀、关节面增生硬化率,低于CT(P<0.05)。结论早期强制性脊柱炎骶髂关节病变患者采用MRI检测敏感,对机体放射损伤低,而CT检查具有空间分辨率高、检出率高等优点,临床上应结合CT和MRI诊断提高确诊率。

Objective To observe the CT and MRI in the early diagnosis of sacroiliac joint disease in patients with acute spondylitis. Methods Sixty-eight patients with sacroiliac joint disease of the early stage of compulsory spondylitis were examined by CT after admission. MRI were performed to compare the results of CT and MRI in the early stage of sacroiliac spondylitis Clinical diagnosis of iliac joint disease. Results There was no significant difference in the rate of sacroiliac joint between grade Ⅱ, grade Ⅲ and grade Ⅳ spondylitis on MRI and CT examination（P〈0.05）. The rate of sacroiliac joint lesion of grade 0 and Ⅲ early MRI was lower than CT（P〉0.05）. MR examination early spondylities sacroiliac joint lesions rate Ⅰ, higher than CT（P〈0.05）. There was no significant difference in the joint space between the two methods（P〉0.05）. MRI examination showed that the rate of sacroiliac joint was significantly higher（P〈0.05）. The rate of osteoarthritis, articular surface sclerosis and articular surface sclerosis were lower than those of CT（P〈0.05）. Conclusion The early diagnosis of sacroiliac joint disease in patients with sacroiliac joint disease is sensitive to magnetic resonance imaging（MRI）. Radiation lesion is low in CT scan. CT has high spatial res-olution and high detection rate, which should be combined with CT and MRI.