MRI在强直性脊柱炎Andersson病变分型中的价值  

The value of MRI in the classification of Andersson lesions in ankylosing spondylitis

作　　者：张恒 崔佳宁 王苹 钱占华 叶薇 詹惠荔 李亚雄 白荣杰 ZHANG Heng;CUI Jianing;WANG Ping;QIAN Zhanhua;YE Wei;ZHAN Huili;LI Yaxiong;BAI Rongjie(Department of Radiology,Beijing Jishuitan Hospital,Capital Medical University,Beijing 100035,China)

机构地区：[1]首都医科大学附属北京积水潭医院放射科,北京100035

出　　处：《国际医学放射学杂志》2024年第5期527-532,共6页International Journal of Medical Radiology

摘　　要：目的探讨MRI对强直性脊柱炎Andersson病变分型,并分析不同分型累及的椎单元情况,为强直性脊柱炎的早期诊断和治疗提供影像学依据。方法回顾性纳入行全脊柱MRI检查的强直性脊柱炎Andersson病变病人77例,其中男69例、女8例,平均年龄(44.0±12.2)岁。收集病人的一般临床资料和全脊柱MRI影像资料。由2名医师分析Andersson病变的MRI影像特征及其累及椎单元的特点,并根据Kim分型将该病变分为Ⅰ-Ⅴ型。采用Kappa检验分析2名医师对Andersson病变分型的一致性。结果2名医师诊断Andersson病变分型的一致性较好(κ=0.694,P<0.001)。Andersson病变共累及229个椎单元,208个椎单元仅存在1种分型病变,Ⅰ-Ⅴ型Andersson病变分别累及30(13.1%)、57(24.9%)、13(5.7%)、85(37.1%)、23(10.0%)个椎单元;21个椎单元同时存在2种分型的病变,Ⅰ+Ⅱ型有18个,Ⅱ+Ⅲ型1个,Ⅰ+Ⅲ型2个。结论MRI可清晰显示强直性脊柱炎的Andersson病变,并可对Andersson病变进行分型,对强直性脊柱炎的早期诊断与治疗方案的制定具有重要价值。Objective To explore the classification of Andersson lesions in ankylosing spondylitis(AS)using MRI and analyze the vertebral units involved in different classifications,providing imaging evidence for the early diagnosis and treatment of AS.Methods All of 77 patients with ankylosing spondylitis who underwent whole spinal MRI were retrospectively included,with 69 males and 8 females,and an average age of 44.0±12.2 years.General clinical data and whole-spine MRI images of the patients were collected.Two physicians analyzed the MRI characteristics of Andersson lesions and the involved vertebral units.According to Kim’s classification,the lesions were classified into typesⅠ-Ⅴ.The Kappa test was used to analyze the consistency between the two physicians in classifying Andersson lesions.Results The consistency between the two physicians in diagnosing and classifying Andersson lesions was good(κ=0.694,P<0.001).A total of 229 vertebral units were involved in Andersson lesions,with 208 vertebral units showing only one type of lesion.TypesⅠ-ⅤAndersson lesions involved 30(13.1%),57(24.9%),13(5.7%),85(37.1%),and 23(10.0%)vertebral units,respectively.Twenty-one vertebral units had two types of lesions simultaneously,with 18 units being typeⅠ+Ⅱ,1 unit typeⅡ+Ⅲ,and 2 units typeⅠ+Ⅲ.Conclusion MRI can clearly display Andersson lesions in ankylosing spondylitis and can be used to classify them,which is of great value for the early diagnosis and treatment plans for AS.

关 键 词：强直性脊柱炎 Andersson病变 鉴别诊断 磁共振成像 

分 类 号：R681.5[医药卫生—骨科学] R445.2[医药卫生—外科学]