摘要
目的分析HRCT结合曲面重建在诊断强直性脊柱炎(AS)骶髂关节病变的诊断价值。方法对96例临床明确诊断AS患者的骶髂关节行高分辨CT扫描及曲面重建,分析其影像表现。结果骶髂关节炎可以双侧或单侧。早期(CTⅠ～Ⅱ级)48例,多累及髂骨侧,表现为骶髂关节髂骨面下小虫蚀样破坏或微小囊变,关节面下轻微硬化,关节面皮质白线中断,略毛糙。中期(CTⅢ级)34例,双侧受累,关节面及关节面下骨侵蚀破坏,呈锯齿样或毛刷样改变,周围骨增生硬化明显,关节面模糊毛糙,可见软骨或韧带钙化,关节间隙不规则狭窄,少数可见真空现象。晚期(CTⅣ级)14例,多双侧受累,关节间隙消失,关节强直,周围骨质疏松。结论 HRCT可显示骶髂关节的细微结构,结合曲面重建在影像表现上提供更全面的范围,因此HRCT具有较高的敏感性和特异性,可做出更早期诊断及明确的分级及分期,为临床治疗提供客观依据。
Objective To explore the application value of high-resolution CT,curve reconstruction in the diagnosis of ankylosing spondylitis（AS） sacroiliac joint.Methods High-resolution CT scan and curve reconstruction were conducted in 96 cases of patients with sacroiliac joint AS,the imaging manifestations were analyzed.Results Sacroiliitis may be unilateral or bilateral.48 cases were at early stage（Ⅰ-Ⅱ grade）,imaging characteristics of sacroiliitis were：iliac side of synovial section mostly involved,slightly insect-bite,subcortical microcysts and mild sclerosis of iliac surface of joint,most cases with symmetric involvement of the joints showed coarse articular surface,interruption or disappearance of the joint cortex.34 cases were at the intermediate stage（Ⅲ grade）,most cases showed bilateral articular surface and subcortical destruction,serrated or brush appearance with vague and irregularity of sacroiliac articular surface.sclerosis or hypertrophic changes around the joints,sacroiliac ligament calcification and irregular narrowing or even vacuumization of the joint space were found.At the late stage（Ⅳ grade）,14 cases;bony ankylosis of the joints with obliteration of joint space and osteoporosis or sclerosis were found.Conclusion HRCT and curve recon can could clearly depicts subtle changes of aacroiliac joint.It was a sensitive and specific technique in the detection of the wide spectrum of imaging findings,accurate earlier diagnosis and correct grading can gained,which can provide objective evidence for clinical optimized treatment.
出处
《中华全科医学》
2012年第8期1301-1303,共3页
Chinese Journal of General Practice
关键词
强直性脊柱炎
骶髂关节
高分辨CT
曲面重建
Ankylosing spondylitis
Sacroiliac joint
High-resolution CT
Curve reconstruction
