CT和MRI诊断AS患者骶髂关节面下骨质侵蚀的价值比较

Comparison of the value of CT and MRI in diagnosing subsurface bone erosion of sacroiliac joint in AS patients

目的分析CT和磁共振成像(MRI)诊断强直性脊柱炎(AS)患者骶髂关节面下骨质侵蚀的价值。方法180例疑似AS患者,按照检测方法不同分为CT组和MRI组,各90例。CT组采用CT检测,MRI组采用MRI检测。比较两组骶髂关节病变检出率、骶髂关节病变等级的检出率及诊断准确性、灵敏度及特异度。结果两组增生硬化、关节腐蚀的检出率比较差异无统计学意义(P>0.05)。MRI组关节面下骨质囊变、骨髓水肿的检出率分别为85.56%、81.11%,均高于CT组的62.22%、54.44%,差异有统计学意义(P<0.05)。MRI组检测骶髂关节病变1、2级检出率高于CT组,差异有统计学意义(P<0.05)。两组骶髂关节病变0、3、4级检出率比较,差异无统计学意义(P>0.05)。MRI组检测准确性、灵敏度高于CT组,差异有统计学意义(P<0.05)。结论MRI诊断AS患者骶髂关节面病变效果优于CT。

Objective To analyze the value of CT and magnetic resonance(MRI)in diagnosing subsurface bone erosion of sacroiliac joint in ankylosing spondylitis(AS)patients.Methods A total of 180 patients with suspected AS patients were divided into CT group and MRI group according to different test methods,with 90 cases in each group.CT group was tested by CT,and MRI group was tested by MRI.The detection rate of sacroiliac joint lesions,detection rate of sacroiliac joint lesion grade,diagnostic accuracy,sensitivity and specificity were compared between the two groups.Results There was no statistically significant difference in detection rate of hyperplasia and sclerosis,joint corrosion between the two groups(P>0.05).The detection rate of bone cyst degeneration and bone marrow edema under the articular surface of MRI group were 85.56%and 81.11%,which were higher than 62.22%and 54.44%of CT group,and the difference was statistically significant(P<0.05).The detection rate of sacroiliac joint lesion grade 1 and 2 of MRI group was higher than that of CT group,and the difference was statistically significant(P<0.05).There was no statistically significant difference in detection rate of sacroiliac joint lesion grade 0,3 and 4 between the two groups(P>0.05).The detection accuracy and sensitivity of MRI group were higher than those of CT group,and the difference was statistically significant(P<0.05).Conclusion MRI has better effect than CT in diagnosing sacroiliac joint lesions in AS patients.