多层螺旋CT对强直性脊柱炎骶髂关节病变的诊断价值  

Diagnostic value of MSCT for acroiliac joint changes in ankylosing spondylitis

作　　者：雷振[1] 李羽佳[2] 徐娜[1] 张军[1] 

机构地区：[1]辽宁医学院附属第一医院放射线科,辽宁锦州121000 [2]中国医科大学,辽宁沈阳110001

出　　处：《中国现代医学杂志》2011年第32期4032-4035,共4页China Journal of Modern Medicine

摘　　要：目的探讨强直性脊柱炎(AS)骶髂关节改变的多层螺旋CT(MSCT)的诊断价值。方法回顾性分析158例经临床证实的AS患者的骶髂关节MSCT表现特点,包括部位和数量、钙化、关节间隙变化及关节面下骨质改变和分级等。结果该组158例患者骶髂关节病变Ⅲ级者最多,共70例;AS骶髂关节病变双侧同时受累多见,96例患者以累及骶髂关节滑膜部髂骨侧为主;关节间隙改变主要表现为狭窄或消失,其中关节间隙狭窄113例,关节间隙消失11例;绝大多数患者关节面均匀受累,155例患者关节面毛糙及骨质破坏,153例患者见不同程度增生硬化,关节面及关节面下骨质结构囊变34例,46例患者见不同程度骨质疏松;124例患者骶髂关节间隙滑膜部见穿透性钙化,骶髂韧带钙化63例,65例患者骶髂关节骨赘形成。结论 MSCT可以揭示AS骶髂关节病变不同阶段的特点并能够对AS进行准确的分级。[Objective] To investigate the diagnostic value of MSCT （muhi-slice spiral computer tomography） for sacroiliac joint changes （SIPC） in ankylosing spondylitis （AS）. [Methods] A retrospective analysis was made on the manifestations of MSCT of the sacroiliac joints in 158 cases which had been proved to be AS clinically and it is including site and number, calcification, the grading, joint space and bone chariges inferior articular surface. [Results] There are 70 cases in the third grade arthropathy of sacroiliac joint in all 158 cases and it is most. It is common that lesion of arthropathy of sacroiliac joint in ankylosing spondylitis happens bilaterally and it is primary that synovium segment of sacroiliac joint in ilium is involved in 96 cases. It shows stenosis or disappearance was the main alteration of joint space and they are 113 cases and 11 cases respectively. Uniform involvement of articular surface can be displayed in majority patients and some features can be indicated includingi11 defined articular surface and destruction of bone. Hyperplasy and hardening in different degrees have been shown in 153 cases and cystic degeneration and bone rarefaction in various levels are 34 cases and 46 cases respectively. Penetrativity calcification can be revealed in synovium segment of sacroiliac joint and it is 124 cases. Calcification in iliosacral ligament and formation of osteophyma in joint can be also displayed and they are 63 cases and 65 cases respectively. [ Conclusion ] Image of MSCT of AS in sacroiliac joint can demenstrate the characteristic in different period and it is more accurate in grading lesions.

关 键 词：强直性脊柱炎 骶髂关节病变 多层螺旋CT 

分 类 号：R684[医药卫生—骨科学]