外周肌腱附着点超声检查在强直性脊柱炎诊断中的价值  

Value of ultrasonography of peripheral enthesopathy in diagnosis of ankylosing spondylitis

作　　者：邱君斓[1] 张华勇[1] 张炜炜[1] 沈祎[1] 蒋智明[1] 孙凌云[1] 

机构地区：[1]南京大学医学院附属鼓楼医院,江苏省210008

出　　处：《江苏医药》2015年第9期1011-1014,I0001,共5页Jiangsu Medical Journal

摘　　要：目的探讨肌腱附着点超声检查诊断强直性脊柱炎(AS)的价值。方法 20例AS患者,病程1-8(4.3±3.1)年。采用高频线阵探头(频率7-12MHz)对6对肌腱附着点进行超声检查。临床检查时,患者有肌腱附着点部位自主疼痛、肿胀或压痛之一则定义为肌腱附着点炎。结果 AS患者肌腱附着点炎的超声诊断率高于临床检查(51.3%vs.19.6%)(P<0.05)。AS患者肌腱附着点病变在超声上主要表现为肌腱插入骨皮质部位出现钙化(33.3%)、肌腱水肿(29.2%)、血流灌注(25.8%)、肌腱增厚(22.1%)、骨皮质不规则(12.9%)、骨侵蚀(9.6%)和滑囊炎(7.1%)。47处临床检查肌腱附着点阳性病变中,44.7%超声检查未发现异常;而193处临床阴性附着点中,49.2%超声提示存在附着点病变。结论超声检查可发现肌腱附着点结构和炎性病变,可作为AS患者临床检查的补充手段。Objective To investigate the value of ultrasonography of peripheral enthesopathy in the diagnosis of ankylosing spondylitis（AS）. Methods Six pairs of entheseal sites were examined with ultrasnography （high-frequency linear array probe, 7-12 MHz） in 20 AS patients with the disease course of 1-8（4. 3 ± 3.1） years. Clinical enthesopathy was defined by the presence of at least one of the clinical manifestations of spontaneous pain, tenderness pain elicited by pressure and local swelling of the entheses. Results The positive diagnosis rate was higher by ultrasonography than that by clinical examination （51.3% vs. 19.6% ） （P〈0. 05 ）. The abnormalities most commonly found on ultrasonography were calcifications （ 33.3 % ）, hypoechogenicity （ 29.2 %）, blood perfusion （ 25.8 % ）, thickening（22. 1%） ,bone irregularity（12.9%） ,erosions（9.6%） and bursitis（7. 1%）. Of 47 sites with clinical positive manifestations, 44. 7% sites reported by ultrasonography were negative. Of 193 sites with clinical negative manifestations, 49.2% sites reported by ultrasonography were positive. Conclusion Ultrasonography can detect the structural and inflammatory abnormalities of the entheses in AS patients and may be taken as a complemental examination for evaluating enthesitis.

关 键 词：超声 强直性脊柱炎 

分 类 号：R445[医药卫生—影像医学与核医学]