【摘要】：目的探討CT和MRI在早期強直性脊柱炎骶髂關節(jié)病變診斷中的應用價值。方法對接受診治的強直性脊柱炎患者分別采用CT和MRI進行檢查,比較兩種檢查方法的診斷效果。結果 MRI在強直性脊柱炎骶髂關節(jié)病變分級診斷中對0級和I級病變患者的診斷率明顯高于CT檢查,且差異具有統(tǒng)計學意義。而兩種檢查方法在其他級別的強直性脊柱炎骶髂關節(jié)病變分級診斷率比較則無明顯差異。MRI檢查對關節(jié)面下骨質囊變、腰5骶1關節(jié)突病變及骨髓水腫的檢出率明顯高于CT檢查,且差異具有統(tǒng)計學意義。而CT檢查在關節(jié)侵蝕和關節(jié)面增生硬化檢出率方面明顯高于MRI檢查,且差異具有統(tǒng)計學意義。兩種檢查方法對關節(jié)間隙狹窄或增寬的檢出率無明顯差異。結論 MRI檢查方法敏感,無放射性,CT檢查強直性脊柱炎骶骼關節(jié)病變具有更高的空間分辨率,對關節(jié)侵蝕和關節(jié)面增生硬化等早期癥狀的檢出率高于MRI,所以MRI檢查應作為AS早期診斷的優(yōu)選檢查方法,但對一些顯示不清楚的病情變化,要結合CT掃描來確診。
[Abstract]:Objective to evaluate the value of CT and MRI in the diagnosis of sacroiliac joint lesions in ankylosing spondylitis. Methods the patients with ankylosing spondylitis were examined by CT and MRI respectively. Results the diagnostic rate of MRI in the classification of sacroiliac joint lesions in ankylosing spondylitis was significantly higher than that in CT, and the difference was statistically significant. However, there was no significant difference between the two methods in the diagnosis rate of sacroiliac joint lesions in other grades of ankylosing spondylitis. The detection rate of subarticular bone cysts, lumbar 5 sacral process lesions and bone marrow edema by MRI was significantly higher than that of CT. The difference was statistically significant. The detection rate of joint erosion and hyperplastic sclerosis in CT was significantly higher than that in MRI, and the difference was statistically significant. There was no significant difference between the two methods in detecting narrowing or widening of joint space. Conclusion MRI is sensitive and nonradioactive, and CT has higher spatial resolution in detecting sacroiliac joint lesions in ankylosing spondylitis. The detection rate of early symptoms such as joint erosion and hyperplastic sclerosis of articular surface was higher than that of MRI,. Therefore, MRI should be used as an excellent method for the early diagnosis of AS, but for some unclear changes of the disease, the diagnosis should be confirmed by combining CT scan.
【作者單位】： 廣東省深圳市龍華新區(qū)人民醫(yī)院放射科;
【分類號】：R593.23;R816.8;R445.2

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