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目的探讨分析磁共振成像(MRI)诊断早期强直性脊柱炎骶髂关节病变的临床应用价值,并与CT、X线等影像学检查方法进行对比。方法 27例强直性脊柱炎患者,均分别接受X线、CT以及MRI多序列检查,分析X线、CT以及MRI图像特点,并比较三种检查方法对强直性脊柱炎的诊断效能。结果 MRI 0级和Ⅰ级强直性脊柱炎骶髂关节病变的诊断效能显著优于CT和X线,差异有统计学意义(P<0.05)。MRI和CT、X线Ⅱ级及以上骶髂关节病变的诊断效能比较差异无统计学意义(P>0.05)。CT与MRI对关节间隙狭窄或增宽的检出率比较差异无统计学意义(P>0.05);CT检查对关节面增生硬化以及关节侵蚀检出率高于MRI、X线(P<0.05),而MRI对骨髓水肿、腰5骶1关节突病变以及关节面下骨质囊变的检出率高于CT、X线(P<0.05)。结论对于早期强直性脊柱炎骶骼关节病变,MRI可清晰显示病变部位和程度,具有较高的诊断效能,结合CT检查有助于发现早期关节面增生硬化和关节侵蚀等症状。
Objective To investigate the clinical value of magnetic resonance imaging (MRI) in the diagnosis of sacroiliac joint disease of ankylosing spondylitis and to compare with the imaging methods such as CT and X-ray. Methods Twenty - seven patients with ankylosing spondylitis were examined by X - ray, CT and MRI respectively. The features of X - ray, CT and MRI were analyzed. The diagnostic efficacy of the three methods was compared with that of ankylosing spondylitis. Results MRI 0 and grade Ⅰ ankylosing spondylitis sacroiliac joint disease diagnostic efficacy was significantly better than the CT and X-ray, the difference was statistically significant (P <0.05). MRI and CT, X-ray and above grade II sacroiliac joint disease diagnostic efficacy was no significant difference (P> 0.05). CT and MRI showed no significant difference in the detection rate of stenosis or widening of joint space (P> 0.05). The detection rate of CT on joint surface hyperplasia and joint erosion was higher than MRI and X-ray (P <0.05) , And the detection rate of MRI on bone marrow edema, lumbosacral-1 sacral-facet joint disease and articular surface osteoid change was higher than that of CT and X-ray (P <0.05). Conclusions For sacroiliac joint lesions of ankylosing spondylitis, MRI can clearly show the location and extent of lesions and has high diagnostic efficacy. Combined with CT examination, it is helpful to find the symptoms of early articular surface hyperplasia and joint erosion.