摘要
目的分析磁共振成像(MRI)诊断早期强直性脊柱炎(AS)骶髂关节(SIJ)病变分级的临床价值。方法选取2017年4月至2018年6月我院收治的早期AS患者88例为研究对象,均行CT及MRI检查,对比两种检查方法下影像特征及在SIJ病变分级中的诊断价值。结果 CT检查发现早期AS患者SIJ关节间隙变窄且模糊,关节面见骨质破坏,呈锯齿状,多发小囊变,髂骨侧及关节中、下部受累,Ⅰ-Ⅱ级病变者MRI可见骨质关节面模糊粗糙、骨髓水肿、骨质软骨受损,T1WI、T2WI、短时反转恢复序列(STIR)多为低或等信号,Ⅲ-Ⅳ级患者MRI可见明显炎性病变、骨髓水肿、骨质软骨受损、滑膜厚度增加、脂肪沉积,T1WI、T2WI高信号,STIR信号不均匀或不完整;MRI对AS患者SIJ病变Ⅰ级、Ⅱ级的检出率高于CT(P<0.05),两种检查方法对0级、Ⅲ级、Ⅳ级的检出率比较差异无统计学意义(P>0.05);MRI检查对关节面下骨质囊变、关节侵蚀、关节面增生硬化、腰5骶1关节突病变、软组织肿胀的检出率均高于CT(P<0.05);以病理结果为准,MRI对早期SIJ病变分级(0-Ⅱ级)诊断的正确率高于CT,而在晚期SIJ病变分级(Ⅲ-Ⅳ级)诊断方面,CT、MRI的正确率比较差异无统计学意义(P>0.05)。结论 MRI在早期AS患者SIJ病变分级中有较高临床价值,可作为首选检查方法评估骶髂关节改变、脊柱及其附属结构的早期改变。
Objective To analyze the clinical value of magnetic resonance imaging(MRI)in the diagnosis oflesion classification of sacroiliac joint(SIJ)in early ankylosing spondylitis.Methods 88patients with early AS in the hospital from April 2017 to June 2018 were chosen in the study.All patients were given CT and MRI examination.The imaging characteristics and the diagnostic value in SIJ lesion classification with the two methods were compared.Results CT examination found that the SIJ space in the patients with early AS was narrow and fuzzy,the joint surface showed destroyed bone in a jagged shape and multiple small cystic lesions,the side of ilium and the middle and lower parts of the joints were involved.MRI showed that there were fuzzy and roughbone joint surface,bone marrow edema and bone cartilagein patients with grade I to II lesions.T1WI,T2WI and short-term inversion recovery sequence(STIR)showed low or equal signals.MRI of patients with grade IIIIV lesions showed obvious inflammatory lesions,bone marrow edema,osteocartilage damage,increased synovial thickness and fat deposition.T1WI and T2WI showed high signal and STIR signal was inhomogenous or incomplete.The detection rates of grade I and II SIJ lesions in AS patients by MRI were higher than CT(P<0.05).There was no significant difference in the detection rate of grade 0,grade III or grade IV lesions between the two examination methods(P>0.05).The rates of bone cystic change under articular surface,joint erosion,articular surface hyperplasia and sclerosis,facet joint lesions at the 5th lumbar segment and the 1st sacral segment and soft tissue swelling detected by MRI were higher thanCT(P<0.05).With pathological results as the standard,the correct rate of MRI diagnosis for early SIJ lesions(grade 0-II)was higher than that of CT while there was no significant difference in the correct rate between CT and MRI in terms of the diagnosis of advanced SIJ lesions(grade III to IV)(P>0.05).Conclusion MRI is of greatclinical value in the classification of SIJ lesions in pati
作者
李风莲
LI Feng-lian. MRI Room(The People's Hospital of Hebi,Hebi 458030,Henan Province,China)
出处
《中国CT和MRI杂志》
2019年第5期137-140,共4页
Chinese Journal of CT and MRI
关键词
MRI
早期
强直性脊柱炎
骶髂关节病变
MRI
Early
Ankylosing Spondylitis
Sacroiliac Joint Lesion
Classification
Clinical Value
