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目的:研究强直性脊柱炎的骶髂关节病变的影像表现。探讨影像学对强直性脊柱炎的骶髂关节病变影像学诊断价值。方法:对临床确诊的69例强直性脊柱炎的双侧SIJ摄X线平片,同时作CT扫描。总结其影像表现及病变分级,作平行对照研究,并进行统计分析。结果:强直性脊柱炎的骶髂关节病变的患者主诉以髋部疼痛、腰痛、弯腰受限、颈椎受限出现的百分率依次为:49.27%、36.23%、13.03%、1.44%。X-ray骶髂关节影像表现正常、关节变毛糙、模糊、硬化、关节融合的检出率分别为:13.04%、57.97%、27.53%、1.44%;CT分别为:0%、53.62%、44.92%、1.44%。X-ray与CT诊断的符合率从0级～Ⅳ级分别为:0%、15.38%、60.0%、76.92%、100%。结论:强直性脊柱炎的骶髂关节病变X线平片的早期不敏感,对临床怀疑而平片难以确诊的早期病变,CT检查有较高价值。平片表现为早期病变(0～Ⅱ级)的患者CT对其分级更为准确,可提高1～2个级别。
Objective: To study the imaging manifestations of sacroiliac joint lesions in ankylosing spondylitis. To investigate the imaging diagnosis of sacroiliac joint lesions in ankylosing spondylitis. Methods: Sixty-nine patients with ankylosing spondylitis were examined by bilateral SIJ radiographs and CT scans simultaneously. To summarize the imaging findings and grading of lesions, make a parallel-controlled study and conduct statistical analysis. Results: Patients with sacroiliac joint disease of ankylosing spondylitis complained of hip pain, lumbago, and limited bending. The percentages of cervical spine confinement were 49.27%, 36.23%, 13.03% and 1.44%, respectively. The detection rates of X-ray sacroiliac joint images were normal, and the detection rates of joint rough, fuzzy, sclerosis and joint fusion were 13.04%, 57.97%, 27.53% and 1.44%, respectively; CT were 0%, 53.62% and 44.92 %, 1.44%. The coincidence rates of X-ray and CT were 0%, 15.38%, 60.0%, 76.92% and 100% from 0 to 4, respectively. Conclusions: The early stage of X-ray films of sacroiliac joint lesions in ankylosing spondylitis is not sensitive at early stage. It is of great value in the early stage of lesions and CT examination which are difficult to diagnose in plain film. Patients with early lesions (grade 0 ~ Ⅱ) with plain radiographs were more accurately classified by CT, which improved by 1 to 2 levels.