骶髂关节常见CT退变征象:不同年龄及性别间的比较  

Common CT Signs of Sacroiliac Joint Degeneration: Comparison of Different Ages and Sexes

作　　者：李瑞利[1] 黄振国[2] 李宏军[1] 李香凝[2] 

机构地区：[1]首都医科大学附属北京佑安医院放射科,100069 [2]中日友好医院放射科,北京100029

出　　处：《临床放射学杂志》2016年第10期1556-1559,共4页Journal of Clinical Radiology

摘　　要：目的探讨骶髂关节生理性退变CT表现,以提高与病理改变间的鉴别诊断水平。方法对无明确腰骶部临床症状,且扫描范围包括骶髂关节的375例患者的CT资料进行回顾性分析,应用χ2检验统计分析各种退行性改变征象在不同年龄段、不同性别间的发生几率。结果关节间隙狭窄少见,发生几率不随年龄的增长而增加,各年龄段男女间差异均无统计学意义（P值均〉0.05）。骨赘均发生在30岁以上,随年龄的增长发生几率逐渐增加,各年龄段同龄的女性发生几率高于男性,30-39岁组、40-49岁组,差异有统计学意义（P〈0.05）。关节面硬化男性少见,60岁以上发生几率最高,仅为23%;女性关节面硬化发生率高,并呈现两个高峰年龄段,分别为20-29岁70%,60岁以上68%;各年龄段同龄的女性发生几率高于男性,差异均有统计学意义（P值均〈0.05）。关节面下小囊状改变,男性、女性高发年龄段均为60岁以上,各年龄段女性发生几率高于男性,10-19岁组差异有统计学意义（P〈0.05）,余年龄段差异均无统计学意义（P值均〉0.05）。关节面骨侵蚀均发生于60岁以上,女性发生几率（5/40,13%）高于男性（3/40,8%）,差异无统计学意义（P〉0.05）。结论关节间隙狭窄不能单独作为退变征象。女性20-29岁关节面硬化出现高峰可能为妊娠所致。关节面下小囊状改变见于正常骶髂关节。年轻患者出现骨侵蚀应作为病理性改变。男性退变征象单一,以关节周围骨赘形成为主;同龄女性退变程度较男性重,骨赘、关节面硬化、关节面下小囊状改变多种退变征象可同时出现。Objective To study the CT manifestations of sacroiliac joint physiological degeneration and to improve the level of differential diagnoses with pathological changes. Methods 375 lower back of symptom-free subjects underwent CT examination,and the scan range includes the sacroiliac joint. We retrospectively analyzed the CT features of the sacroiliac joint in different ages / gender to compare the frequency of degenerative changes in the sacroiliac joint by age / gender.Statistical analysis was performed using the χ2test. Results Joint space narrowing is rare and the occurrence rate doesn＇t increase with age. There was no statistically significant difference between men and women in all age groups（ all P〈0. 05）. Osteophytes occur in more than 30 years of age and the occurrence rate increases with increasing age. The incidence rates of osteophytes in women are higher than men in the same age; the differences were statistically significant in 30- 39 years group and 40- 49 years group（ P〈0. 05）. Subchondral sclerosis is rare in men,more than 60 years of age group is most likely to have it and the occurrence rate is only 23%. Sclerosis is common in women and the incidence rates present two peak ages,20- 29 age group（ 70%） and more than 60 age group（ 68%）; the incidence rates of sclerosis in women are higher than men in the same age and the differences were statistically significant in all age groups（ all P〈0. 05）. More than 60 years of age groups both in men and women are most likely to have subchondral cystic change with the incidence rates in women being higher than men in all age groups; the difference was statistically significant in 10- 19 years group（ P〈0. 05） and there were no statistically significant difference in other age groups（ all P〉0. 05）. Erosions occur in more than 60 years of age,the incidence rate in women（ 5 /40,13%） is higher than in men（ 5 /40,8%）,but there was no statistically significant difference（ P〈0. 05）. Conclusion Joint space narrowing

关 键 词：骶髂关节 螺旋CT 年龄 性别 退变 

分 类 号：R816.8[医药卫生—放射医学] R684[医药卫生—临床医学]