AS髖關(guān)節(jié)受累影像學(xué)表現(xiàn)與臨床特點(diǎn)相關(guān)性探討
發(fā)布時(shí)間：2018-09-19 08:16
【摘要】：目的:通過對AS患者一般情況、臨床表現(xiàn)、實(shí)驗(yàn)室檢查、影像學(xué)檢查、診治情況等結(jié)果對比,探討不同影像學(xué)檢查在診斷AS患者髖關(guān)節(jié)受累中的價(jià)值及影像學(xué)表現(xiàn)與臨床特點(diǎn)之間相關(guān)性。方法:收集患者一般信息、臨床表現(xiàn)、實(shí)驗(yàn)室檢查、影像學(xué)檢查(骨盆X線平片、髖關(guān)節(jié)CT及MRI)、診治情況等資料,應(yīng)用獨(dú)立樣本T檢驗(yàn)及Χ2檢驗(yàn)對結(jié)果進(jìn)行分析。結(jié)果:117例AS患者234側(cè)髖關(guān)節(jié)中,X線平片顯示異常為46側(cè),MRI顯示異常為151側(cè);X線平片顯示異常包括:間隙狹窄:34側(cè),股骨頭密度不均:15側(cè),骨質(zhì)破壞:20側(cè),骨質(zhì)硬化:10側(cè),骨質(zhì)增生:8側(cè);MRI顯示異常包括:關(guān)節(jié)積液:110側(cè),滑膜增厚:12側(cè),滑膜強(qiáng)化:21側(cè),骨髓水腫:79側(cè),肌腱端炎:1側(cè),骨質(zhì)破壞:15側(cè),間隙變窄:10側(cè),脂肪沉積:4側(cè)。行CT檢查的88例共176側(cè)髖關(guān)節(jié)中,異常關(guān)節(jié)數(shù)為60側(cè),其中35側(cè)骨破壞未能在X線平片中顯示,43側(cè)骨破壞未能在MRI中顯示。X線平片、CT、MRI顯示髖關(guān)節(jié)異常分別為18.8%(33/176)、34.1%(60/176)和63.6%(112/176),在影像學(xué)顯示髖關(guān)節(jié)受累的敏感度方面,MRI優(yōu)于X線平片和CT(X2值分別為73.19和30.74,P值均0.05)。有髖關(guān)節(jié)影像學(xué)慢性骨結(jié)構(gòu)改變的患者較無慢性骨結(jié)構(gòu)改變的患者發(fā)病年齡小、病程短、病史中有更多髖關(guān)節(jié)疼痛或活動(dòng)受限、BASFI高(P均0.05)。相對于病史中無髖關(guān)節(jié)疼痛或活動(dòng)受限的患者,病史中有髖關(guān)節(jié)疼痛或活動(dòng)受限的患者以頸部為首發(fā)癥狀的患者少、出現(xiàn)髖關(guān)節(jié)影像學(xué)慢性骨結(jié)構(gòu)改變較多(P均0.05),既往接受正規(guī)�？浦委熭^多(P0.05),余(P均0.05)差別無統(tǒng)計(jì)學(xué)意義。結(jié)論:在診斷AS髖關(guān)節(jié)受累的影像學(xué)檢查中,骨盆X線平片只能發(fā)現(xiàn)中、晚期病變,可用于疾病篩查;X線平片、CT和MRI均能顯示AS髖關(guān)節(jié)受累的慢性骨結(jié)構(gòu)改變,但在顯示髖關(guān)節(jié)間隙狹窄方面X線平片敏感度最優(yōu),在顯示微小骨質(zhì)破壞方面,CT敏感度最優(yōu);X線平片和CT不能顯示MRI能顯示的急性炎性期改變。發(fā)病年齡小、病程短、BASFI高、病史中有髖部疼痛或活動(dòng)受限的AS患者更易出現(xiàn)髖關(guān)節(jié)影像學(xué)慢性骨結(jié)構(gòu)改變;以膝關(guān)節(jié)炎為首發(fā)癥狀的AS患者病程中不易發(fā)生髖關(guān)節(jié)慢性骨結(jié)構(gòu)改變。以頸部疼痛或活動(dòng)受限為首發(fā)癥狀的患者病史中出現(xiàn)髖部疼痛或活動(dòng)受限較少,有髖關(guān)節(jié)疼痛或者活動(dòng)受限的患者更易出現(xiàn)髖關(guān)節(jié)影像學(xué)慢性骨結(jié)構(gòu)破壞,更易就診及接受正規(guī)專科治療。
[Abstract]:Objective: to compare the general situation, clinical manifestation, laboratory examination, imaging examination, diagnosis and treatment of AS patients. To explore the value of different imaging examination in the diagnosis of hip involvement in patients with AS and the correlation between imaging findings and clinical features. Methods: the data of general information, clinical manifestation, laboratory examination, imaging examination (pelvis plain film, CT and MRI), diagnosis and treatment of hip joint) were collected, and the results were analyzed by independent sample T test and X 2 test. Results among the 234 cases of AS, 46 sides were abnormal in MRI, 34 sides in narrow space, 15 sides in uneven density of femoral head, 20 sides in bone destruction, 10 sides in bone sclerosis, 10 sides of bone sclerosis, 34 sides of narrow gap, 15 sides of uneven density of femoral head, 20 sides of bone destruction, 10 sides of bone sclerosis. The MRI findings of 8 sides of osteomatous hyperplasia included: synovial thickening: 1 / 110, synovial thickening: 12, synovial enhancement: 21, bone marrow edema: 1: 79, tendonitis: 1, bone destruction: 15, gap narrowing: 10, fat deposition: 4. The abnormal number of hip joints was 60 in 88 patients with 176 sides of hip joint examined by CT. Among them, 35 sides of bone destruction could not be shown in X-ray plain film. 43 sides of bone destruction could not be displayed in MRI. The abnormal rate of hip joint was 18.8% (33 / 176), 34.1% (60 / 176) and 63.6% (112 / 176), respectively. MRI was superior to X-ray plane in the sensitivity of imaging showing hip involvement. CT and X _ 2 values were 73.19 and 30.74 (P < 0. 05, respectively). The patients with chronic bone structure changes in hip imaging were younger than those without chronic bone structure changes, the course of disease was shorter, and there were more hip pain or limited movement in the history (all P 0.05). The neck was the first symptom in patients with history of hip pain or limited movement, compared with those with no hip pain or limited movement. There were more chronic bone structure changes in hip imaging (all P 0.05), more regular specialist treatment in the past (P0.05), and no significant difference in the rest (P 0.05). Conclusion: in the imaging examination of AS hip joint involvement, pelvic X-ray plain film can only find middle and late lesions, and can be used to screen the disease screening X ray plain film CT and MRI can show the chronic bone structure changes of AS hip joint involvement. But the X-ray radiographic sensitivity was the best in showing the stenosis of the hip joint space, and the CT sensitivity was the best in showing the small bone destruction. The X-ray plain film and CT could not show the acute inflammatory phase changes that MRI could show. AS patients with low onset age, short course of disease and high BASFI, with history of hip pain or limited movement, were more likely to have chronic bone structure changes in hip joint imaging. Chronic bone structure changes of hip joint are not easy to occur in patients with AS with knee arthritis as the first symptom. Patients with neck pain or limited movement were less likely to suffer from hip pain or motion restriction in their history, and those with hip pain or motion limitation were more likely to suffer from chronic bone structure destruction in hip imaging. It is easier to see a doctor and receive regular specialist treatment.
【學(xué)位授予單位】：石河子大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2015
【分類號(hào)】：R593.23
本文編號(hào)：2249559
[Abstract]:Objective: to compare the general situation, clinical manifestation, laboratory examination, imaging examination, diagnosis and treatment of AS patients. To explore the value of different imaging examination in the diagnosis of hip involvement in patients with AS and the correlation between imaging findings and clinical features. Methods: the data of general information, clinical manifestation, laboratory examination, imaging examination (pelvis plain film, CT and MRI), diagnosis and treatment of hip joint) were collected, and the results were analyzed by independent sample T test and X 2 test. Results among the 234 cases of AS, 46 sides were abnormal in MRI, 34 sides in narrow space, 15 sides in uneven density of femoral head, 20 sides in bone destruction, 10 sides in bone sclerosis, 10 sides of bone sclerosis, 34 sides of narrow gap, 15 sides of uneven density of femoral head, 20 sides of bone destruction, 10 sides of bone sclerosis. The MRI findings of 8 sides of osteomatous hyperplasia included: synovial thickening: 1 / 110, synovial thickening: 12, synovial enhancement: 21, bone marrow edema: 1: 79, tendonitis: 1, bone destruction: 15, gap narrowing: 10, fat deposition: 4. The abnormal number of hip joints was 60 in 88 patients with 176 sides of hip joint examined by CT. Among them, 35 sides of bone destruction could not be shown in X-ray plain film. 43 sides of bone destruction could not be displayed in MRI. The abnormal rate of hip joint was 18.8% (33 / 176), 34.1% (60 / 176) and 63.6% (112 / 176), respectively. MRI was superior to X-ray plane in the sensitivity of imaging showing hip involvement. CT and X _ 2 values were 73.19 and 30.74 (P < 0. 05, respectively). The patients with chronic bone structure changes in hip imaging were younger than those without chronic bone structure changes, the course of disease was shorter, and there were more hip pain or limited movement in the history (all P 0.05). The neck was the first symptom in patients with history of hip pain or limited movement, compared with those with no hip pain or limited movement. There were more chronic bone structure changes in hip imaging (all P 0.05), more regular specialist treatment in the past (P0.05), and no significant difference in the rest (P 0.05). Conclusion: in the imaging examination of AS hip joint involvement, pelvic X-ray plain film can only find middle and late lesions, and can be used to screen the disease screening X ray plain film CT and MRI can show the chronic bone structure changes of AS hip joint involvement. But the X-ray radiographic sensitivity was the best in showing the stenosis of the hip joint space, and the CT sensitivity was the best in showing the small bone destruction. The X-ray plain film and CT could not show the acute inflammatory phase changes that MRI could show. AS patients with low onset age, short course of disease and high BASFI, with history of hip pain or limited movement, were more likely to have chronic bone structure changes in hip joint imaging. Chronic bone structure changes of hip joint are not easy to occur in patients with AS with knee arthritis as the first symptom. Patients with neck pain or limited movement were less likely to suffer from hip pain or motion restriction in their history, and those with hip pain or motion limitation were more likely to suffer from chronic bone structure destruction in hip imaging. It is easier to see a doctor and receive regular specialist treatment.
【學(xué)位授予單位】：石河子大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2015
【分類號(hào)】：R593.23
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