CT与X线对早期强直性脊柱炎的诊断  

Diagnoses of CT scan and X-ray film with the early ankylosing spondylitis

作　　者：马进[1] 严修明[1] 胡久民[1] 陈玉峰[1] 

机构地区：[1]郧阳医学院附属人民医院放射科,湖北十堰442000

出　　处：《罕少疾病杂志》2005年第5期16-19,共4页Journal of Rare and Uncommon Diseases

摘　　要：目的评价CT扫描与X线平片对早期强直性脊柱炎的诊断价值。方法回顾性分析我院收治33例临床确诊为强直性脊柱炎患者骶髂关节的X线及CT影像资料,通过影像表现进行病变分期及统计学分析。结果早期强直性脊柱炎骶髂关节病变的影像表现为:髂骨侧关节面模糊,皮质部分或完全消失,靠近皮质部的松质骨增生、硬化、糜烂、浓密不均呈融雪状,骨小梁模糊,随病程延长可向骶骨侧与韧带部发展,关节内软组织肿胀等。CT扫描与X线平片对早期病变(Ⅰ～Ⅱ期)的检出两者有显著性差异(P<0.05),对Ⅲ～Ⅳ期病变检出无明显差异(P>0.05)。结论对早期强直性脊柱炎病例,骶髂关节的CT扫描较X线平片能更好地显示局部细微病变情况,对病变早期发现与分期更准确,应作为首选检查方法。CT复查对拟诊Ⅰ期病例的确诊、病变的演变情况和评价治疗效果有重要意义。Objective To evaluate the effect of CT scan and X-ray films in the diagnosis of sacroiliac joint in patients with early ankylosing spondylitis （AS）. Methods By reviewing the X-ray films, CT scan and reexamination of 33 cases of the ankylosing spondylitis sacroiliac joints, we put the lesions into various staging by imaging manifestations. All the data were studied by statistics. Results The sacroiliac joint in the early AS had the following imaging characteristics：The cortex of the joint surface at tile ilium side was hazy with part or all of the cortex disappeared, the trabecula adjacent to the joint surface of the ilium hardly identified. It was thawing that tile bone has been erosion and ossified with inhomogenous density . As the disease exacerbated, the lesions aggregated toward sacrum and ligamenta sides. Soft tissues swollen could also be seen. There were significant differences in early （ Ⅰ - Ⅱ of stages） lesion between CT scan and X-ray films being discovered early the lesions and no significant defference in m- iv stages. Conelusion As CT examination can show tiny structures of lesions in the early stages of AC, improve the accuracy in early diagnosis as well as clinical staging ,it should be first suggested. CT reexamination is very useful in discerning the stage Ⅰ lesions and the extent, progress and prospect of AS.

关 键 词：骶髂关节 强直性脊柱炎 体层摄影术 X线计算机 

分 类 号：R684.3[医药卫生—骨科学] R814.42[医药卫生—外科学]