强直性脊柱炎腰椎骨突关节病变的MSCT和MRI诊断  

Multislice spiral CT and MRI in the diagnosis of zygapophyseal joint lesions in patients with ankylosing spondylitis

作　　者：陈芳妮[1] 李绍林[1] 张锐[1] 莫贤福 胡绍勇[1] 赵英华[1] 

机构地区：[1]南方医科大学第三附属医院医学影像中心,广州医学硕士研究生510630

出　　处：《医学研究生学报》2014年第7期713-717,共5页Journal of Medical Postgraduates

基　　金：广东省科技计划项目基金(2012B031800134);广州市医药卫生科技项目基金(20121A011181)

摘　　要：目的强直性脊柱炎(ankylosing spondylitis,AS)可累及腰椎骨突关节和椎体,文中比较多排螺旋CT和MRI对腰椎骨突关节病变的诊断价值,进而评估骨突关节病变对AS的早期诊断价值。方法回顾性分析41例男性AS患者的影像资料。全部患者行MSCT检查,18例患者行MRI平扫,23例患者行MRI平扫DWI和增强T1WI压脂序列扫描。采用Fisher确切概率检验比较MSCT和MRI对骨突关节病变的检出率,以及对腰椎骨突关节病变与椎体病变的检出率;分析骨突关节病变与病程的关系。结果 MSCT对骨突关节与椎体病变的检出率分别为90.2%、58.5%(P>0.05),MRI对骨突关节与椎体病变的检出率分别为80.5%、46.3%(P>0.05)。MSCT和MRI对AS骨突关节病变的检出率差异无统计学意义(P>0.05),对AS椎体病变的检出率差异有统计学意义(P<0.05)。骨突关节病变可以出现于起病1年内及椎体病变产生之前。结论 MSCT和MRI均能够显示腰椎骨突关节病变;骨突关节病变可出现在AS早期,早于椎体病变,提示该征象有可能成为早期诊断AS的依据。Objective Ankylosing spondylitis （AS） can affect both the lumbar zygapophyseal joint and the centrum .This study was to compare multislice spiral CT （ MSCT） and MRI in the diagnosis of zygapophyseal joint lesions in AS patients and assess the role of zygapophyseal joint lesions in the early diagnosis of AS . Methods We retrospectively analyzed the lumbar imaging data of 41 male patients with AS .Forty-one male AS patients underwent MSCT , 18 receiving normal MRI , and the other 23 diffusion weighted imaging （DWI） and CE-T1WI-STIR in addition.Using Fisher′s Exact Test, we compared MSCT and MRI in their detection rates of a-pophyseal joint lesions and positive changes in the zygapophyseal joint and lumbar centrum .Then we analyzed the relation between the zygapophyseal joint lesions and the disease duration . Results The detection rates of zygapophyseal joint and centrum lesions were 90.2%and 58.5%on MSCT （P〉0.05）, and 80.5%and 46.3%on MRI （P〉0.05）, respectively.MSCT and MRI exhibited sig-nificant differences in the detection rate of centrum lesions （P〈0.05） but not in that of zygapophyseal joint lesions （P〉0.05）. These lesions could appear within 1 year after the onset of AS or ahead of vertebral changes . Conclusion Both MSCT and MRI can manifest zygapophyseal joint lesions , which may develop in the lumbar spine at the early stage of AS , ahead of centrum lesions .This is important for the early diagnosis of AS .

关 键 词：强直性脊柱炎 腰椎 骨突关节 多排螺旋CT MRI 

分 类 号：R681.53[医药卫生—骨科学]