摘要
目的探讨幼年强直性脊椎炎的影像学改变,提高对本病的认识。方法本组12例,男性11例、女性1例。发病年龄为9～16岁,平均为13岁。所有病例均摄取骨盆平片,双侧骶髂关节斜位。其中4例作了CT及MRI平扫检查。并作了类风湿因子、人类白细胞抗原HLA-B27等实验室检查。结果本组病例病变均累及骶髂关节,其中5例并累及双侧髋关节。X线表现:双侧骶髂关节下2/3处骨质硬化,尤以髂骨侧为甚。骶髂关节面模糊,关节间隙宽窄不等,呈锯齿状改变。累及髋关节者,表现为髋臼和股骨头软骨面下小囊状透光区,关节间隙不规则变窄。C平扫:患侧骶髂关节显示关节间隙宽窄不等,关节面下小囊状透光区。MTRI平扫:T显示患侧骶髂关节间1WI隙宽窄不等,骶髂关节旁可见低信号灶,该低信号灶在TWI压脂扫描时可显示为高信号。HLA-B27阳性。结论2幼年强直性脊椎炎因早期缺乏成人强直性脊椎炎的典型临床表现,常被误诊为幼年性类风湿性关节炎少关节型。但这是两种不同的疾病,治疗方法和转归不尽相同。应提高对本病的认识,我们认为影像学检查和HLA-B27检查,可对本病作出早期和正确的诊断。
Objective To research the image change of JAS and improve the knowledge of this case.Method 12 patients in this group, 11 males and 1 female. The morbidity age is between 9- 16 years old and in average is 13 years old. All the cases use the pelvis platform and R F, HLA- B27 check.. Four of them has made the CT and MRI level. Result In this group, the case is extended over the sacroiliac joint. Among them, there are 5 samples that are referred to both of the coxa articution. The X - rays shows that under the sacroiliac joint, there has 2/3 sclerotin sclerotized and the side of sacroiliac shows this phenomenon especially. The sacroiliac joint is fuzziness and the size of articulation clearance is different, it shows as the sawtooth . When it refers to the coxa articution ,it shows as the acetabular and at the same time the articulation become abnormally. When it refers to the lumber, it shows as that the lumber articulation fuzziness while the articulation clearance disappear. CT level: when affected with this sickness it show that the size of the clearance is different. MRI level: T1WI shows that when affected with this case, it express that the size of the clearance is different and at the side of sacroiliac joint can see the low signal which can change into high signal when put it under the T2WI, HLA- B27 is musculine.Conclusion Because JAS is lack of the adjust ankylosing spondylitis special clinical in the early stage, so it is always be misdiagnosed as the Juvenile rheumatiod arthitis. In fact they are two different cases and treatment is also different. We should improve our knowledge about this case. In our opinion, checking of the image and HLA- B27 can diagnose this sickness earlier and correctly. [
出处
《影像诊断与介入放射学》
2005年第1期39-41,共3页
Diagnostic Imaging & Interventional Radiology
