高分辨CT扫描在强直性脊柱炎早期诊断的应用研究  

Application research on high-resolution computed tomography in early diagnosis of ankylosing apondylitis

作　　者：林顺发[1] 林珏慧[1] 吴敏[1] 周实[1] 王庆文[2] 

机构地区：[1]汕头大学医学院第一附属医院放射科,广东汕头515041 [2]汕头大学医学院第一附属医院风湿病科,广东汕头515041

出　　处：《中国现代医学杂志》2006年第22期3468-3470,共3页China Journal of Modern Medicine

摘　　要：目的探讨高分辨CT对强直性脊柱炎骶髂关节炎的早期诊断价值。方法对40例临床拟诊成人型强直性脊柱炎的患者进行常规横断CT扫描及多层螺旋CT薄层高分辨率扫描,分别对骶髂关节炎的CT表现及分级进行分析,并在CT引导下对该组病人进行骶髂关节穿刺活检,将CT结果分别与病理结果相对比。结果40例中病理诊断骶髂关节炎36例,其中常规横断CT扫描诊断骶髂关节炎的35例中,30例诊断正确,准确率85.7%,病变分级为1～2级的病例诊断准确率70.6%,3～4级准确率100%。假阳性5例,假阴性4例;多层螺旋CT薄层高分辨率扫描诊断骶髂关节炎39例中,36例诊断正确,准确率92.3%,病变分级1～2级准确率85.7%,3～4级准确率100%。假阳性2例,假阴性1例。结论多层螺旋CT薄层高分辨率扫描能清晰显示骶髂关节的细微病理变化,有助于强直性脊柱炎的早期诊断及对疾病的分级评估。[Objective] To explore the early diagnostic value of using high-resolution computed tomography in ankylosing spondyhtis and sacroiliitis. [Methods] 40 cases of imitated adult patients with ankylosing spondylitis underwent routine intersect CT scan and high-resolution lamellar multislice spiral CT scan. The CT images and ranking of sacroiliitis were analyzed respectively, following the CT-guided piqure biopsy on cacroiliac joint. CT result was contrasted with pathology result. [Results] 36 of 40 cases were pathologically diagnosed as sacroiliitis, among them, 30 of 35 cases underwent routine intersect CT scan were correctly diagnosied, accurate rate reached 85.7%. Accurate diagnosis rate of affection ranking 1-2 was 68% while that of ranking 3-4 hit 100%. 5 cases were false positive, 4 cases were false negative; 32 of 34 cases underwent high-resolution lamellar multislice spiral CT scan were correctly diagnosied as sacroiliitis, accurate rate reached 94.1%. Accurate diagnosis rate of affection ranking 1- 2 was 80.7% wihle that of ranking 3-4 hit 100%. 2 cases were false positive, 1 case was false negative. [Conclusions] High-resolution lamellar multislice spiral CT scan can clearly display tiny pathological change of cacroiliac joint, which greatly conduces to early diagnosis of ankylosing spondylitis and ranking evaluation on disease.

关 键 词：骶髂关节炎 高分辨率 多层螺旋CT 

分 类 号：R814.42[医药卫生—影像医学与核医学]