强直性脊柱炎骶髂关节的CT诊断价值  

CT diagnosis of sacroiliac arthropathy in patients with ankylosing spondylitis

作　　者：张永军[1] 

机构地区：[1]山西焦煤集团古交矿区总医院放射科,山西太原030200

出　　处：《实用医学影像杂志》2009年第5期305-307,共3页Journal of Practical Medical Imaging

摘　　要：目的探讨强直性脊柱炎(AS)患者骶髂关节病变的CT表现,并评价其对早期诊断的意义。方法对46例经临床证实AS患者骶髂关节病变的CT表现进行了回顾性分析,并参照修订的AS纽约标准(5级分类法)对全部患者的骶髂关节病变进行了分级。结果研究证实,本组46例均有异常CT表现。其中,Ⅱ级(早期,7例)CT表现为骶髂关节受累,关节面轻度硬化、毛糙,皮质白线消失,关节面细小囊变,但关节间隙仍正常;Ⅲ级(进展期,35例)CT表现为骶髂关节面呈虫蚀状侵蚀,软骨钙化,关节面骨质增生硬化,关节间隙略增宽或不均匀变窄;Ⅳ级(晚期,4例)CT表现为关节骨性强直,关节间隙消失。结论CT能清晰显示骶髂关节的微细结构及其病理改变,极有利于诊断AS患者早期骶髂关节病变。Objective To study the CT findings of sacroiliac arthropathy in patients with ankylosing spondylitis （AS） and to evaluate their significance for early diagnosis. Methods CT findings of sacroiliac arthropathy in 46 patients with clinically proved AS were retrospectively analyzed and graded based on a modified New York criteria for AS （elassifycation of five grades）. Results CT scans showed abnormal CT findings of sacroiliac joints in all patients. Of whom, grade Ⅱ （early stage, n=7） appeared as involvement of sacroiliac joints, light sclerosis and coarseness of the articular surfaces, disappearance of the cortical white line, and small cystic change of the articular surfaces, but the articular spaces were still normal grade Ⅲ （progressive stage, n=35） appeared as insect bite-form erosion of the articular surfaces, calcification of the cartilages, bony proliferation and sclerosis of the articular surfaces, and lightly widening or non-homogeneously narrowing of the articular spaces; grade Ⅳ （advanced stage, n=4） appeared as bony rigidity of the sacroiliac joints and disappearance of the articular spaces. Conclusion CT may clearly reveal the small structures of sacroiliac joint and their pathologic changes so that it is very helpful to diagnose the early sacroiliac arthropathy in patients with AS.

关 键 词：强直性脊柱炎 骶髂关节病 体层摄影术 X线计算机 

分 类 号：R816.8[医药卫生—放射医学]