MRI与CT在诊断早期强直性脊柱炎骶髂关节病变中的效果比较

Magnetic resonance imaging versus CT in the early diagnosis of ankylosing spondylitis patients complicated with sacroiliac joint lesions

目的探讨磁共振成像(MRI)与电子计算机断层扫描(CT)诊断早期强直性脊柱炎(AS)骶髂关节病变的效果。方法选择AS骶髂关节病变患者150例,先后进行CT与MRI诊断。比较CT与MRI对AS分级的检出率与总检出率,以及对AS各种征象的检出效果。结果 MRI对ASⅠ级、Ⅱ级检出率及总检出率均显著高于CT(P <0. 05)。MRI与CT对ASⅢ级与Ⅳ级检出率比较无显著差异(P <0. 05)。MRI对AS关节面下骨质囊变、关节面侵蚀、关节面增生硬化的检出率显著高于CT(P <0. 05); MRI与CT对AS关节间隙狭窄或增宽、关节软骨肿胀的检出率比较,差异无统计学意义(P> 0. 05)。结论MRI诊断早期AS骶髂关节病变的效果,以及对关节面下骨质囊变、关节面侵蚀、关节面增生硬化等早期症状检出率均优于CT,可作为早期AS骶髂关节病变的首选诊断技术。

Objective To investigate the effects of magnetic resonance imaging （MRI） and computed tomography （CT） on the early diagnosis of ankylosing spondylitis patients complicated with sacroiliac joint lesions. Methods Totally 150 AS patients with sacroiliac joint lesions were selected and conducted with CT and MRI successively. The detection rate and total detection rate of AS grading and the detection effect of various signs of AS were compared between CT and MRI. Results For the detection of grade Ⅰ and Ⅱ of AS, the detection rate and total detection rate of MRI were significantly higher than CT （ P 〈0.05）. There were no significant difference in detecting grade Ⅲ and Ⅳ of AS between MRI and CT （ P 〈0.05）. The detection rates of AS joint surface osseous cysts, joint surface erosion, joint surface hyperplasia and sclerosis by MRI were significantly higher than those by CT （ P 〈0.05）, and there were no significant difference in the detection rates of stenosis or widening of joint space and swelling of articular cartilage in AS joint between CT and MRI （ P 〉0.05）. Conclusion The results of MRI for early diagnosis of AS patients with sacroiliac joint lesions, as well as the detection rate of early symptoms of osseous cystosis, joint surface erosion, joint surface hyperplasia and sclerosis are superior to CT, which can be used as the first choice for the early diagnosis of AS patients with sacroiliac joint lesions.