强直性脊柱炎早期CT表现─白边征  

White-borderline sign on CT at the early period of ankylosing spondylitis

作　　者：马新发[1] 关春爽[2] 崔盾 田志三 李艳明 

机构地区：[1]首都医科大学附属北京友谊医院放射科,北京100050 [2]北京丰台医院放射科,北京100071 [3]赤峰市宁城县中蒙医院放射科,内蒙古赤峰024000 [4]赤峰市敖汉旗医院MR室,内蒙古赤峰024000

出　　处：《中国医学影像技术》2013年第4期625-627,共3页Chinese Journal of Medical Imaging Technology

摘　　要：目的探讨强直性脊柱炎患者中骶髂关节白边征的形态学表现及临床意义。方法收集92例强直性脊柱炎患者,均接受骶髂关节CT检查,分析其影像学表现,并进行统计学分析。结果白边征表现为CT图像上骶髂关节髂骨关节面骨皮质带状、不均匀骨质致密区,骨缘不光滑。92例中,双侧骶髂关节受累84例(84/92,91.30%),单侧骶髂关节受累8例(8/92,8.70%);单纯髂骨面受累73例(73/92,79.35%)。骶髂关节炎Ⅰ级19例(19/92,20.65%),其中白边征9例(9/19,47.37%);Ⅱ级24例(24/92,26.09%),其中白边征13例(13/24,54.17%);Ⅲ级35例(35/92,38.04%),Ⅳ级14例(14/92,15.22%),均未见白边征。Ⅰ级、Ⅱ级及Ⅲ级以上骶髂关节炎中白边征出现率的差异有统计学意义(χ2=33.218,P<0.001)。结论骶髂关节白边征是AS的早期CT征象,可以考虑将其作为骶髂关节炎分级的参考指标。Objective To explore the morphological appearances and clinical value of white-borderline sign on CT in pa- tients with early period ankylosing spondylitis （AS）. Methods Ninety-two patients with sacroiliitis were collected and un- derwent sacroiliac join1 CT scanning. The imaging were reviewed and statistically analyzed. Results The white-borderline sign meant that the iliac posterior margin of the sacroiliac joint was irregular and the bone density was uneven. Among 92 patients, bilateral sacroiliac joints involvement were found in 84 （84/92, 91.30%）, and unilateral sacroiliac joint involve- ment were found in 8 patients （8/92, 8.70%）. Seventy-three patients （73/92, 79.35%） only appeared as ilium erosion. There were 19 patients （19/92, 20. 65%） with grade I saeroiliitis, 24 （24/92, 26.09%） with gradelI, 35 （35/92, 38. 04%） with grade Ⅲ and 14 （14/92, 15. 22%） with grade 1V sacroiliitis. The white-borderline sign only appeared in pa- tients of grade I （9/19, 47.37%） and gradeⅡ（13/24, 54. 17%） sacroiliitis. The occurrence rate of white-borderline sign among grade I , grade Ⅱ and above grade Ⅲ sacroiliitis had significant differences （2 =33. 218, P〈0. 001）. Conclusion The white-borderline sign of sacroiliac joints is helpful to diagnose early period AS, and may be used as a reference of the grading of sacroiliitis.

关 键 词：脊柱炎 强直性 骶髂关节炎 体层摄影术 X线计算机 

分 类 号：R814.42[医药卫生—影像医学与核医学] R593.23[医药卫生—放射医学]