SAPHO综合征骶髂关节病变的CT表现

The CT Manifestations of SAPHO Syndrome with Sacroiliac Joint Involvement

目的:观察分析SAPHO综合征骶髂关节病变的CT表现特征,增进对该病的认识.方法:经骨扫描证实35例SAPHO综合征骶髂关节受累患者行CT检查,应用骶髂关节炎1984年修订纽约分类标准进行病变评估,分析其临床资料及CT表现特征.结果:35例患者骶髂关节病变关节双侧受累为80.0%(28/35),病变大致对称为22.9%(8/35),单侧受累20.0%(7/35);病变髂骨侧为主61.4%(43/70),骶骨侧为主8.51%(6/70),双侧大致相同10.0%(7/70);滑膜部受累92.9%(65/70),韧带部受累47.14%(33/70),无单独韧带部受累病变.Ⅰ~Ⅳ级分别为11.40%(4/35)、17.1%(6/35)、65.7%(23/35)及5.7%(2/35),所有病变髂上/髂下,骶上/骶下分布无统计学差异(P>0.05).结论:CT可准确反映SAPHO综合征骶髂关节病变的双侧、髂骨、滑膜部受累为主的特征,早期骨质破坏,中晚期骨质硬化为主,强直少见,为诊断及治疗提供帮助.

Objective:To observe the CT imaging findings of patients with sacroiliac joint(SIJ)lesions of SAPHO syndrome and to improve our understanding of the disease.Methods:Thirty-five patients with SAPHO syndrome and SIJ involvement evidenced by bone scintigraphy were recruited.The 1984 revision of modified NewYork(mNY)criteria was used to evaluate SIJs on CT in patients with sacroiliitis.The clinical data,the distribution and degree of lesions involved SIJ were evaluated.Results:All the 35 patients exhibited abnormalities in the SIJ on CT.Among these patients,80.0%(28/35)patients were involved bilaterally and 20.0%(7/35)unilaterally.The lesions were detected mainly in the iliac in 61.4%(43/70)patients and in the sacrum in 8.51%(6/70)patients.Both the iliac and the sacrum were equally involved were 10.0%(7/70).92.9%(65/70)patients were involved in the anteroinferior synovial membrane,and 47.14%(33/70)patients in the posterosuperior ligament.Grade I to IV were 11.40%(4/35),17.1%(6/35)65.7%(23/35)5.7%(2/35)respectively.Distribution of lesions in the upper/lower iliac bone and upper/lower sacrum were no statistical difference(P>0.05).Conclusion:SIJs are usually bilaterally involved in SAPHO patients,with a predilection for iliac synovial membrane.CT manifestations are characterized by the destruction in the early stage,and osteosclerosis in the mid-later stage,with a low prevalence of ankylosis.These CT features may be new diagnostic clues for SAPHO syndrome.