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价值研究

Application of X ray, CT and MRI in the diagnosis of early ankylosing spondylitis

目的研究早期强直性脊柱炎(AS)骶髂关节病变诊断中X线、CT、MRI检查的应用价值。方法选取98例AS骶髂关节病变患者临床资料,均行X线、CT、MRI检查,比较三种诊断结果。结果 CT、MRI的AS骶髂关节病变检出率91.84%、100.00%均比X线71.43%高,且MRI检出率100.00%比CT 91.84%高(P<0.05);在AS骶髂关节病变分级中,MRI的O级检出率7.14%均比X线0.00%、CT 0.00%高;CT、MRI的Ⅰ级(29.59%、34.69%)、检出率均比X线11.22%高(P<0.05);X线、CT、MRI的Ⅲ级(均为20.41%)、Ⅳ级(均为10.20%)检出率比较差异无统计学意义;在关节面异常表现中,CT、MRI的侵蚀检出率87.76%、94.90%均比X线67.35%高,CT、MRI的骨质囊变检出率72.45%、86.73%均比X线40.82%高,且MRI检出率比CT高;CT、MRI的间隙变窄(39.80%、39.80%)、软骨肿胀(16.34%、21.43%)检出率均比X线25.51%、0.00%高(P<0.05);X线、CT、MRI的间隙变宽(63.27%、69.39%、70.41%)、下骨质硬化(68.37%、73.47%、75.51%)检出率比较均无统计差异。结论 X线、CT、MRI均能检出早期AS骶髂关节病变,其中X线是最为基础的检查手段,诊断价值有限;在分级、关节面表现诊断中,MRI的诊断效果最为显著,MRI能清楚检出骨质病变情况,其次是CT检查。

Objective To study the diagnostic value of X-ray, CT and MRI in the diagnosis of sacroiliac joint lesions in early ankylosing spondylitis. Methods The clinical data of 98 patients with AS sacroiliac joint lesions were examined by X-ray, CT and MRI, compare the three diagnostic results. Results The results of CT, MRI and AS of sacroiliac joint lesion detection rate of 91.84% and 100.00% higher than X-ray（71.43%）, and the detection rate of MRI was 100.00% higher than CT（91.84%）（P〈0.05）; AS in sacroiliac joint lesion classification, O detection rate of MRI were7.14% higher than X-ray（0.00%） and CT（0.00%）; CT, MRI the（29.59%, 34.69%）, the detection rate was 11.22% higher than X-ray（P〈0.05）;grade CT, X-ray, MRI（20.41%）, IV（10.20%） the detection rate showed no statistical difference; abnormalities in articular surface, erosion of CT, the detection rate of MRI 87.76% and 94.90% were 67.35% higher than X-ray; CT and MRI in bone cystic change detection rate of 72.45% and 86.73%were 40.82% higher than X-ray; and the detection rate of MRI is higher than CT, CT, MRI of the narrow gap（39.80%, 39.80%）,（16.34%, 21.43%）cartilage swelling detection rate were 25.51% and 0.00% higher than X-ray（P〈0.05）; There was no statistical difference between line, X, CT, MRI gap widening（63.27%, 69.39%, 70.41%）, and lower osseosclerosis（68.37%, 73.47%, 75.51%）. Conclusion The X-ray, CT, MRI were detected in early AS lesions of sacroiliac joint X-ray, which is the most basic means of inspection and diagnosis of limited value; in the classification and diagnosis of the articular surface, the diagnostic effect of MRI most significant, MRI can clearly detect bone lesions, followed by CT examination.