肌骨超声与多模态影像在强直性脊柱炎诊断中的对比研究

Musculoskeletal ultrasonography and multimodality imaging in the diagnosis of ankylosing spondylitis:a comparative study

目的分析比较肌骨超声、X线、CT、MRI及实验室指标对强直性脊柱炎(AS)的诊断效能,探讨肌骨超声诊断AS的临床应用价值。方法选取我院拟诊为AS的患者82例,均行肌骨超声、X线、CT、MRI、血清超敏C反应蛋白和红细胞沉降率检查,根据人类白细胞抗原检测结果,分为阳性69例(病例组)和阴性13例(对照组),分析并比较肌骨超声与上述其他检查方式在AS临床诊断中的效能。结果两组性别比、年龄、血清高敏C反应蛋白、红细胞沉降率比较,差异均无统计学意义;两组超声、CT、X线、MRI的AS阳性检出率比较,差异均有统计学意义(均P<0.05);超声与X线、CT、MRI对AS的检出率比较,差异均无统计学意义。超声与MRI诊断AS炎症期的检出率比较差异无统计学意义。超声与实验室炎症指标在判断骶髂关节炎症方面比较差异无统计学意义。结论肌骨超声可以作为诊断AS的重要影像学手段,特别是在AS炎症期,超声检出率可以媲美MRI。

ObjectiveTo analyze and compare the diagnostic efficacy of musculoskeletal ultrasound,X-ray,CT,MRI and laboratory test indexes in the diagnosis of ankylosing spondylitis(AS),and to explore the clinical application value of musculoskeletal ultrasound in the diagnosis of AS.Methods patients underwent musculoskeletal ultrasound,X-ray,CT,MRI,serum hypersensitive C-reactive protein and erythrocytes sedimentation rate examinations.According to the results of human leukocyte antigen,they were divided into positive group(case group,n=69)and negative group(control group,n=13).The efficacy of musculoskeletal ultrasound and other examination methods in the clinical diagnosis of AS was analyzed and compared.Results age,serum hyper sensitive C-reactive protein,erythrocytes sedimentation rate between two groups.There were significant difference in the positive detection rate of AS by ultrasound,CT,X-ray,MRI between two groups(all P<0.05).There was no significant difference in the detection rate of AS among ultrasound,X-ray,CT and MRI.There was no significant difference in the detection rate between ultrasound and MRI in the diagnosis of AS in the inflammatory stage.There was no statistical significance between ultrasound and laboratory inflammatory indicators in the diagnosis of sacroiliac joint inflammation.ConclusionMusculoskeletal ultrasound can be used as an important imaging method in the diagnosis of AS,especially in the inflammatory stage of AS,and the detection rate of ultrasound is comparable to that of MRI.