摘要
目的探讨磁共振成像(MRI)对强直性脊柱炎(AS)早期骶髂关节炎(SIJ)诊断的临床应用价值.方法收集2014年6月至2016年1月期间深圳市坪山新区人民医院收治确诊的52例AS患者为研究对象,均保留完整的临床和影像资料,观察AS患者SIJ的MRI影像表现,通过与CT检查结果比较,回顾性分析MRI诊断SIJ及病变分级的准确度.结果 MRI能较好显示AS患者SIJ的解剖结构和关节病变等信息,MRI主要表现以关节软骨不规则变粗、扭曲和信号异常为主;MRI、CT对SIJ的诊断准确度均较高,分别为100%(52/52)、94.23%(49/52),二者相较差异无统计学意义(χ~2=2.039,P>0.05);以随访确诊复查、部分病理结果为SIJ分级诊断金标准,MRI、CT检查对SIJ病变分级的诊断准确率分别为96.15%(50/52)、86.54%(45/50),二者相较差异无统计学意义(χ~2=3.041,P>0.05),但MRI在SIJ早期病变(II^III级)诊断上准确率96.43%(27/28)较CT分级诊断78.57%(22/28)明显较高,二者差异具有统计学意义(χ~2=4.082,P<0.05).结论 MRI对AS早期SIJ的诊断准确度和CT较为接近,但在SIJ早期病变分级诊断上优于CT,临床根据诊断需要采用MRI检查,可为早期AS诊断及SIJ程度评估提供重要依据.
Objective To investigate the clinical value of magnetic resonance imaging （MRI） in the diagnosis of early AS （SIJ） in patients with ankylosing spondylitis （as） . Methods From June 2014 to January 2016, 52 cases of AS patients in our hospital were selected as the research object, clinical and imaging data were retained intact. MRI imaging of AS on patients with SIJ was compared with the results of CT examination, then the accuracy of MRI and SIJ in diagnosis and grading analysis was reviewed. Results MRI could better display the anatomical structure and joint lesions of AS in patients with SIJ, MRI mainly showed irregular thickening of articular cartilage, distortion and abnormal signal; the accuracy of MRI and CT for SIJ diagnosis were higher, respectively 100% （52/52） , 94.23% （49/52） , there was no statistically significant difference between two methods （ x^ 2= 2.039, P〉0.05） . The pathological results confirmed by review and follow-up were regarded as the gold standard for SIJ classification in diagnosis, the accuracy of MRI and CT in diagnosis of SIJ lesion classification were 96.15% （50/52） , 86.54% （45/50） , there was no statistically significant difference （x^2 =3.041, P〉0.05） . The diagnostic accuracy rate of MRI in SIJ early lesions （II -III） was 96.43% （27/28） , and significantly higher than that of CT [78.57% （22/28） ], there was a statistically significant difference （ x^2 =4.082, P〈0.05） Conclusion The accuracy of MRI and CT are similar in diagnosis of early AS SIJ, but MRI is better than SIJ in early diagnosis of CT lesion classification, MRI examination should be selected according to clinical need, and can provide an important basis for early diagnosis and evaluation of SIJ AS.
出处
《昆明医科大学学报》
CAS
2017年第3期98-102,共5页
Journal of Kunming Medical University
基金
深圳市坪山新区科研基金资助项目(201521)
作者简介
吴晓涛，男，本科，主治医师，主要从事骨骼系统影像CT及MRI诊断工作．
