CT与MRI在诊断早期强直性脊柱炎骶髂关节病变中的临床意义

Clinical Significance of CT and MRI in the Diagnosis of Sacroiliac Joint Lesions in Early Ankylosing Spondylitis

目的探讨计算机断层扫描(CT)、磁共振成像(MRI)在早期强直性脊柱炎(AS)骶髂关节病变中的诊断价值。方法选取在2019年7月至2021年7月商城县人民医院就诊的148例疑似AS骶髂关节病变患者,所有患者入院时均行CT、MRI检查,以临床检查结果为“金标准”,比较CT、MRI检查单独、联合诊断结果、诊断效能及对AS病理特征的检出率。结果经临床检查显示,148例疑似AS骶髂关节病变患者共确诊115例;经CT检查结果显示,共确诊98例;经MRI检查显示,共确诊101例;经联合检查结果显示,共确诊113例;与CT、MRI检查单独诊断比较,联合诊断灵敏度(94.78%)、准确率(93.24%)较高,漏诊率(5.22%)较低(P<0.05)。与CT、MRI检查单独诊断比较,联合诊断对于关节面下骨质囊变、关节面侵蚀检出率较高(P<0.05)。结论CT、MRI联合检查可有效提高AS骶髂关节病变检出率,临床可通过其进行早期诊断、制定相应治疗方案。

Objective To investigate the diagnostic value of electron computed tomography(CT)and magnetic resonance imaging(MRI)in early ankylosing spondylitis(AS)sacroiliac joint lesions.Methods A total of 148 patients with suspected AS sacroiliac joint lesions attending Shangcheng People’s Hospital from July 2019 to July 2021 were selected,and all patients underwent CT and MRI examinations on admission.The clinical examination results were taken AS the“gold standard”,and the diagnostic results,diagnostic efficacy,and the detection rate of pathological features were compared between CT and MRI alone and in combination.Results Clinical examination showed that a total of 148 patients with suspected AS sacroiliac joint lesions were diagnosed in 115 cases.CT examination showed that a total of 98 cases were diagnosed.MRI examination showed that a total of 101 cases were diagnosed.Combined examination showed that a total of 113 cases were diagnosed.Compared with CT and MRI examinations alone,the combined diagnosis had higher sensitivity(94.78%)and accuracy(93.24%),and a lower rate of missed diagnosis(5.22%)(P<0.05).Compared with CT and MRI examinations alone,the combined diagnosis had a higher detection rate for subarticular bone cystic lesions and articular surface erosion(P<0.05).Conclusion CT and MRI combined examination can effectively improve the detection rate of AS sacroiliac joint lesions,which can be used to make early diagnosis and formulate corresponding treatment plans in clinical practice.