CT与X线对早期强直性脊柱炎的诊断  

CT scan and X-ray film to diagnose the early ankylosing sacroiliac

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,十堰442000

出　　处：《山西医科大学学报》2005年第5期633-636,共4页Journal of Shanxi Medical University

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33例临床确诊的强直性脊柱炎骶髂关节X线平片、CT片和复查片,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、了解病变的演变情况和评价治疗效果有重要意义.Objective To evaluate the diagnostic value of CT scanning and radiography in the early ankylosing spondylitis （AS）. Methods By retrospective analysis of X-ray films, CT scanning and reexamination of 33 cases of ankylosing spondylitis sacroiliac joints, the lesion staging was made by imaging manifestations. All the data were analysed by statistics. Results The sacroiliac joint in early AS had the following imaging manifestations： the cortex of joint surface at ilium side was hazy, and a part or all of the cortex disappeared. The trabecula adjacent to the joint surface of the ilium was hardly identified. The bone showed erosion and ossify with inhomogenous density and seemed thawing snow. Following extended course of disease the lesions were progressed toward sacrum and ligamenum sides,and swollen soft tissues in joint space,etc. There was significant difference in early （stages Ⅰ -Ⅱ ） lesion between CT scan and X -ray films discovered and no significant difference in stages Ⅲ - Ⅳ. Conclusion CT examination as a first-selected method is necessary to the sacroiliac joint in early stages of AS, and can show tiny structure of lesions. It can improve the correct rate to discover early the lesions and put the lesions into various staging. CT reexamination is very helpful for diagnosing the stage I lesion and determining the extent.

关 键 词：骶髂关节 脊柱炎 强直性 体层摄影术 X线计算机 

分 类 号：R593.23[医药卫生—内科学] R814.4[医药卫生—临床医学]