郭威　曾照志　刘明标

[摘要] 目的 探讨强直性脊柱炎骶髂关节病变应用MRI与CT的诊断价值。 方法 将2015年1月～2016年1月在我院诊断为强直性脊柱炎患者38例作为观察对象，分别进行CT、MRI检查。 结果 MRI检查诊断关节面侵蚀、关节面下骨质囊变、关节面增生硬化的检出率显著高于CT检查（P<0.05），但两种检查诊断关节间隙增宽或狭窄、关节软骨肿胀的检出率比较，差异无统计学意义（P>0.05）。MRI检查诊断强直性脊柱炎骶髂关节病变的Ⅰ级检出率显著高于CT检查，而CT检查诊断强直性脊柱炎骶髂关节病变的0级检出率显著低于MRI检查，差异有统计学意义（P<0.05），但两种检查方法诊断强直性脊柱炎骶髂关节病变的Ⅱ、Ⅲ、Ⅳ检出率比较，差异无统计学意义（P>0.05）。 结论 CT与MRI诊断强直性脊柱炎骶髂关节病变均具有较好的诊断价值，但MRI检查更有利于细微病变的检出，更具有一定的诊断优势。

[关键词] 强直性脊柱炎；骶髂关节病变；MRI；CT

[中图分类号] R593.23 [文献标识码] B [文章编号] 1673-9701（2017）26-0103-03

Value of MRI and CT in the diagnosis of sacroiliac joint lesions in ankylosing spondylitis

GUO Wei ZENG Zhaozhi LIU Mingbiao

CT Room， the People's Hospital of Changle County in Shandong Province， Changle 262400， China

[Abstract] Objective To investigate the value of MRI and CT in the diagnosis of sacroiliac joint lesions in ankylosing spondylitis. Methods From January 2015 to January 2016， 38 patients with ankylosing spondylitis diagnosed in our hospital were selected as observation objects， and CT and MRI examinations were performed respectively. Results MRI diagnosis of articular surface erosion， articular surface， bone cystic hyperplasia of the articular surface hardening rate was significantly higher than that of CT examination， the difference was statistically significant（P<0.05）， but two kinds of diagnosis of joint gap widened or narrow， articular cartilage swelling ratehad no significant difference（P>0.05）. The detection rate of MRI diagnosis of sacroiliac joint in ankylosing spondylitis Ⅰ level was significantly higher than that of CT examination and CT examination in the diagnosis of sacroiliac joint in ankylosing spondylitis 0 detection rate was significantly lower than that of MRI examination， the difference was statistically significant（P<0.05）， but two kinds of method for diagnosis of theⅡ， Ⅲ， Ⅳdetection rate of fault level comparison of sacroiliac joint in ankylosing spondylitis had no significant difference （P>0.05）. Conclusion CT and MRI have good diagnostic value in the diagnosis of sacroiliac joint in ankylosing spondylitis， but MRI is more conducive to the detection of subtle lesions， and has more advantages in diagnosis.

[Key words] Ankylosing spondylitis； Sacroiliac joint lesions； MRI； CT

強直性脊柱炎（ankylosing spondylitis，AS）是一种主要累及骶髂关节的慢性自身免疫性炎症性疾病[1]，其诊断以往主要通过X线检查进行诊断。目前CT与MRI检查成为强直性脊柱炎的主要检查方法，研究证实，CT具有较高的密度及空间分辨率，对早期骶髂关节病变具有较高的敏感性[2]；而MRI能够清晰显示滑膜、软骨等部位病变，尤其用于强直性脊柱炎早期骶髂关节病变的诊断[3]。本文旨在探讨MRI与CT的诊断强直性脊柱炎早期骶髂关节病变的临床价值，为提高强直性脊柱炎早期骶髂关节病变的诊断准确率提供参考依据，现报道如下。endprint

1 对象与方法

1.1研究对象

将2015年1月～2016年1月在我院诊断为强直性脊柱炎患者38例作为观察对象，其中男28例、女10例。年龄最小23岁，最大76岁，平均（52.1±11.9）岁。病程最短6个月，最长7年，平均（2.1±0.5）年。……