摘要
目的探讨MRI在早期强直性脊柱炎骶髂关节(AS-SIJ)病变诊断中的应用价值。方法选取我院2015年10月至2017年10月收治的疑似AS-SIJ病变患者80例,经SIJ病理学检查、实验室检查结合临床表现确诊68例。患者均在入院3 d内接受X线、CT和MRI检查。分析并比较三种检查方式诊断结果、与临床病理诊断的一致性及其对早期AS分级的评估效果。结果 MRI对关节滑膜、关节软骨肿胀及韧带炎症的检出率均明显高于CT与X线,差异具有统计学意义(P<0.05);CT对关节滑膜、关节软骨肿胀的检出率均明显高于X线,差异具有统计学意义(P<0.05)。X线、CT、MRI与临床病理诊断的一致性Kappa值分别为0.289、0.511和0.645。MRI的Ⅱ级检出率为88.75%,明显高于X线、CT的73.75%和71.25%,差异具有统计学意义(P<0.05)。结论 X线、CT、MRI在早期AS-SIJ病变中均有一定的诊断价值。与X线、CT检查相比,MRI对早期AS-SIJ病变的诊断价值更高,其对关节滑膜、关节软骨肿胀、韧带炎症等检出率较高,与临床病理诊断结果一致性较好,且能对AS病变做出更高分级,可作为早期AS-SIJ病变的重点诊断方法。
Objective To investigate the application value of MRI in the diagnosis of early ankylosing spondylitis-sacroiliac joint (AS-SIJ) lesions. Methods Eighty patients suspected of AS-SIJ lesions admitted in our hospital from October 2015 to October 2017 were selected. Sixty-eight patients were diagnosed by SIJ pathological examination, laboratory examination and clinical manifestations. All patients were examined by X-ray, CT and MRI within 3 days of admission. The diagnostic results, consistency with clinicopathological diagnosis results and evaluation effects of early AS classification among the three methods were analyzed and compared. Results The detection rates of joint synovium, articular cartilage swelling and ligament inflammation by MRI were significantly higher than those by CT and X-ray, the differences were statistically significant (P<0.05);and the detection rates of joint synovium and articular cartilage swelling by CT were significantly higher than those by X-ray, the differences were statistically significant (P<0.05). The consistent Kappa values of X-ray, CT and MRI with clinicopathological diagnosis were 0.289, 0.511 and 0.645, respectively. The detection rate of grade Ⅱ of MRI was 88.75%, which was significantly higher than 73.75% and 71.25% of X-ray and CT, and the differences were statistically significant (P<0.05). Conclusion X-ray, CT and MRI have certain diagnostic value in early AS-SIJ lesions. Compared with X-ray and CT, MRI has higher diagnostic value for early AS-SIJ lesions and higher detection rates for joint synovium, articular cartilage swelling and ligament inflammation, it has good consistency with clinical pathological diagnosis results, and can make a higher grade for AS-SIJ lesions, which can be used as a key diagnostic method for early AS-SIJ lesions.
作者
张军
贾红卫
ZHANG Jun;JIA Hong-wei(the Fourth People's Hospital of Shaanxi, Xi'an 710043, China)
出处
《临床医学研究与实践》
2019年第10期152-154,共3页
Clinical Research and Practice
