彩色多普勒超声在评估强直性脊柱炎患者骶髂关节炎活动性中的价值  

Color Doppler ultrasonography in assessing the activity of sacroiliitis in patients with ankylosing spondylitis

作　　者：漆家高[1] 张馨月[1] 郭道宁[1] 邹晓攀[1] 邹晋梅[2] 何瑜[3] 周孟君[4] QI Jiagao;ZHANG Xinyue;GUO Daoning;ZOU Xiaopan;ZOU Jinmei;HE Yu;ZHOU Mengjun(Department of Ultrasound,Mianyang Central Hospital,Mianyang 621000,China)

机构地区：[1]绵阳市中心医院超声科,四川绵阳621000 [2]绵阳市中心医院风湿免疫科,四川绵阳621000 [3]绵阳市中心医院放射科,四川绵阳621000 [4]绵阳市中心医院信息科,四川绵阳621000

出　　处：《实用医学杂志》2018年第22期3787-3791,共5页The Journal of Practical Medicine

基　　金：四川省绵阳市卫生局项目基金(编号:201138)

摘　　要：目的探讨彩色多普勒超声(CDUS)在评估强直性脊柱炎(AS)患者骶髂关节炎活动性中的价值。方法前瞻性分析经MRI诊断的55例AS患者的101个活动期骶髂关节和31例AS患者的60个静止期骶髂关节的CDUS检查资料,对比两组骶髂关节的血流显示、血流分级、血流阻力指数(RI)、关节内血流、关节外血流、动脉血流、静脉血流、舒张期正相及反相动脉血流等血流指标,比较各指标单独和联合诊断活动期骶髂关节炎的价值。结果两组间血流显示率、血流分级、静脉血流、关节内血流、RI等指标的差异具有统计意义(P <0.05)。进一步Logistic逐步回归分析示两组间RI、静脉血流、血流分级三项指标的差异有统计学意义(P <0.01)。比较三项指标单独诊断活动期骶髂关节炎的ROC曲线,以RI=0.625为临界值诊断的价值最高,敏感度82.4%,特异性82.9%;三项指标联合诊断的曲线下面积(AUC)大于单独诊断任一指标的AUC,敏感度为91.9%,特异性82.9%。结论 CDUS可通过骶髂关节血流RI、血流分级、静脉血流等指标为AS患者骶髂关节炎活动性提供诊断依据,以RI单独诊断价值最高,若联合应用三项指标具有更高的诊断价值。Objective To investigate the value of color Doppler ultrasound(CDUS)in evaluating the activ-ity of sacroiliitis in patients with ankylosing spondylitis(AS).Methods Color Doppler high-frequency ultrasound images and blood flow were compared between 101 active sacroiliac joints in 55 AS patients and 60 inactive sacroil-iac joints in 31 AS patients,and the value of individual indicators and combined diagnostic activity of sacroiliitis were analyzed.Results There were significant difference in blood flow display rates,blood flow grading,venous blood flow,joint blood flow,and RI between the two groups(P<0.05).There were statistically significant differ-ences in RI value,venous blood flow,and blood flow grading between two groups with logistic regression analysis(P<0.05).The ROC curve of the three indexes is compared,taking RI=0.625 for diagnosis of active sacoriliitis in AS patients,the sensitivity and specificity were 82.4%and 82.9%,respectively.The area under the curve(AUC)for combined diagnosis was greater than that for any index alone,and the sensitivity was 91.9%and the specificity was 82.9%.Conclusion CDUS provides a diagnostic basis for the activity of sacroiliitis in AS patients.Combined diagnostic of RI value,blood flow grading,and venous blood improves detection of the activity of sacroiliitis in AS patients.

关 键 词：超声检查 多普勒 彩色 强直性脊柱炎 骶髂关节炎 

分 类 号：R593.23[医药卫生—内科学] R445.1[医药卫生—临床医学]