X线、CT和MRI在早期强直性脊柱炎骶髂关节病变诊断中的价值比较

Comparison of value by X-ray, CT and MRI in diagnosis of early ankylosing spondylitis sacroiliac joint lesion

目的对比X线、CT和磁共振成像(MRI)在早期强直性脊柱炎(AS)骶髂关节病变诊断中的应用价值。方法 57例AS患者分别进行X线、CT和MRI检查,并对检查结果进行对比分析。结果 X线检测关节面侵蚀、关节面下骨质囊变、关节软骨肿胀检出率分别为59.65%、24.56%、0;CT检测分别为71.93%、57.89%、7.02%;MRI分别为82.46%、73.68%、12.28%。CT与MRI对关节面侵蚀、关节面下骨质囊变、关节软骨肿胀的检出率均明显高于X线平片,差异具有统计学意义(P<0.05);CT与MRI在0~Ⅱ级早期病变患者的检出率明显高于X线,差异具有统计学意义(P<0.05);在Ⅲ、Ⅳ级早期病变检出率比较差异无统计学意义(P>0.05)。结论 X线、CT和MRI在早期AS骶髂关节病变的诊断中均具有一定价值,其中MRI检出率明显优于其他两种检测手段。

Objective To compare application value by X-ray, CT and magnetic resonance imaging（MRI） in diagnosis of early ankylosing spondylitis（AS） sacroiliac joint lesion. Methods A total of 57 AS patients received examination respectively by X-ray, CT and MRI, and their examination outcomes were taken into comparative analysis. Results X-ray had detection rate of articular surface erosion, sclerotin cystic lesion inferior articular surface, and articular cartilage swelling respectively as 59.65%, 24.56% and 0, which were 71.93%, 57.89% and 7.02% by CT, and 82.46%, 73.68% and 12.28% by MRI. CT and MRI both had obviously higher detection rate of articular surface erosion, sclerotin cystic lesion inferior articular surface, and articular cartilageswelling than X-ray, and their difference had statistical significance（P〈0.05）. CT and MRI had much higher detection rate of early grade 0～ Ⅱ lesion than X-ray, and the difference had statistical significance（P〈0.05）. There was no statistically significant difference of early grade Ⅲ and Ⅳ lesion（P〈0.05）. Conclusion X-ray, CT and MRI all shows certain value in diagnosis of early AS sacroiliac joint lesion, and MRI provides remarkably better detection rate than the other two measures.