强直性脊柱炎髋关节病变早期影像征象探讨  

Imaging signs of early hip-joint lesions in patients with ankylosing spondylitis

作　　者：黄科峰[1] 赵国宏[1] 应文魁[1] 李继庆[1] 张婷[1] 张林村[1] 

机构地区：[1]中国人民解放军477医院放射科,湖北襄樊441003

出　　处：《实用医学影像杂志》2008年第5期309-311,共3页Journal of Practical Medical Imaging

摘　　要：目的研究强直性脊柱炎髋关节病变的X线平片、CT、MRI表现及其早期征象。方法从65例强直性脊柱炎髋关节病变中筛选出23例资料完整、临床证实的强直性脊柱炎髋关节病变的X线平片、CT及MRI资料进行分析和研究,入组标准:a)有强直性脊柱炎髋关节病变临床症状;b)符合纽约诊断标准;c)X线平片、CT及MRI三种检查资料完整;d)HLA-B27阳性;e)排除股骨头无菌性坏死等其他疾病。结果研究发现髋臼囊变出现率100%,出现在其他异常征象之前,且能独立出现,并存在于强直性脊柱炎髋关节病变全过程。在早期,本组23例中18例髋臼囊变单独存在,而无其他异常征象,在进展期,其他征象如关节间隙变窄、股骨头囊变等均与髋臼囊变并存。结论髋臼囊变是强直性脊柱炎髋关节病变的早期影像征象,且在所有征象中最具特征性,对确定强直性脊柱炎髋关节病变早期诊断有重要价值。Objective To investigate the plain radiography,CT and MRI signs of early hip-joint lesions in patients with ankylosing spondylitis （AS）.Methods Twenty-three patients with hip-joint lesions,who underwent plain radiography,CT and MRI examinations were collected from 65 patients with AS.All the imaging data were comparatively analyzed.The choice criterion of the patients included following five terms：to have clinical symptoms of hip-joint lesions with AS;to correspond to New York criterion;to have complete data of plain radiography,CT and MRI;HLA-B：7 to be positive;and other lesions such as aceptic necrosis of femoral head to be ruled out.Results The study demonstrated that the incidence of acetabular cystoid changes was 100% before onset of other abnormal signs.At early stage,there were 18 of 23 cases whose acetabular cystoid changes were appeared alone without other abnormal signs in the group while at progressive stage,other signs such as narrowing of arthrous spaces and cystoid changes of femoral head were associated with acetabular cystoid change.Conclusion Acetabular cystoid change is an early imaging sign of hip-joint lesions with AS and it is also the most characteristic one of all signs so that it is very valuable for early diagnosis of this disease.

关 键 词：强直性脊柱炎 髋关节 CT MRI X线平片 

分 类 号：R593.23[医药卫生—内科学] R445[医药卫生—临床医学]