超声微血流成像技术在早期活动性强直性脊柱炎骶髂关节中的诊断价值

The value of ultrasonic micro-blood flow imaging in the detection of sacroiliac joint in early active ankylosing spondylitis

目的应用超声微血流成像技术(superb micro-vascular imaging,SMI)检查早期强直性脊柱炎(Ankylosing Spondylitis,AS)患者骶髂关节(Sacroiliac joint,SIJ),并与MRI结果对比,探讨SMI判断早期AS患者骶髂关节炎活动性的价值。方法选择经临床确诊的早期AS患者58例,结合MRI骶髂关节检查,分为活动组30例和非活动组28例,比较两组SIJ的血流显示率、丰富程度及阻力指数(RI)。采用Kappa分析比较超声与MRI诊断的一致性。结果对活动组SIJ血流显示率、血流丰富程度明显高于非活动组,差异有统计学意义(P<0.001),活动组RI低于非活动组,差异有统计学意义(P<0.001)。2.以RI=0.635为最佳临界值,与MRI相比Kappa=0.68。以血流丰富程度(多血流、少血流)为诊断活动性骶髂关节炎的标准,与MRI相比Kappa=0.52。结论SMI技术能够准确判断早期AS患者骶髂关节炎活动性,为临床干预治疗提供一定的理论依据。

Objective Patients with Ankylosing Spondylitis(AS)were examined with superb micro-vascular imaging(SMI),and the Sacroiliac joint(SIJ)was compared with MRI results to explore the value of SMI in judging the activity of Sacroiliac arthritis in patients with early AS.Methods 58 patients with early clinically diagnosed with AS were selected.30 patients were divided into the active group and 28 patients were in the inactive group by MRI examination of sacroiliac joint.Blood flow display rate,richness and resistance index(RI)of SIJ in the two groups were compared.Kappa analysis was used to compare the consistency of ultrasound and MRI diagnosis.Results The SIJ blood flow display rate and blood flow richness in the active group were significantly higher than those in the inactive group,with statistically significant differences(P<0.001),and RI in the active group was lower than that in the inactive group,with statistically significant differences(P<0.001).2.RI=0.635 was taken as the optimal critical value,and compared with MRI,Kappa=0.68.The richness of blood flow(more blood flow,less blood flow)was taken as the criteria for the diagnosis of active sacroiliac arthritis,compared with MRI,Kappa=0.52.Conclusion SMI technology can accurately determine the activity of sacroiliac arthritis in early AS patients and can provide a certain theoretical basis for clinical intervention.