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目的探讨CT对强直性脊柱炎(ankylosing sporidylitis,AS)骶髂关节病变的诊断价值。方法对2010年8月—2013年6月就诊的45例临床确诊AS患者行骶髂关节X线、CT检查,比较两种诊断方法的准确率。计数资料用χ2检验,P<0.05为差异有统计学意义。结果 AS早期骶髂关节改变表现为:骨质侵蚀、虫蚀样破坏,囊变、周围骨硬化等,对于病变征象,X线与CT显示基本相同,但是CT对细微结构显示清楚,能更直观的反映病变的范围及关节间隙的改变,其中Ⅰ、Ⅱ级X线诊断15例,CT诊断30例,Ⅲ、Ⅳ级X线诊断22例,CT诊断15例,Ⅰ、Ⅱ级诊断比较差异有统计学意义(P<0.05),Ⅲ、Ⅳ级诊断无统计学意义(P>0.05)。结论骶髂关节面模糊、骨质侵蚀、破坏、囊变、骨质硬化是AS的早期征象,CT对病变细节显示更清楚对早期病变更具敏感性。
Objective To investigate the diagnostic value of CT in the diagnosis of sacroiliac joint disease in ankylosing spondylitis (AS). Methods 45 patients with clinically diagnosed AS who visited from August 2010 to June 2013 underwent X-ray and CT examination of sacroiliac joint, and the accuracy of the two diagnostic methods was compared. Count data using χ2 test, P <0.05 for the difference was statistically significant. Results The changes of sacroiliac joint in early stage of AS were as follows: bone erosion, erosion of worm-eaten sample, cystic degeneration and peri-osseous sclerosis, etc. The signs of X-ray and CT were basically the same, but the CT showed the microscopic structure clearly and more intuitive Of the lesions and joint space changes, including Ⅰ, Ⅱ grade X-ray diagnosis of 15 cases, CT diagnosis of 30 cases, Ⅲ, Ⅳ grade X-ray diagnosis of 22 cases, 15 cases of CT diagnosis, Ⅰ, Ⅱ-level diagnosis of the difference was Statistical significance (P <0.05), Ⅲ, Ⅳ grade diagnosis was not statistically significant (P> 0.05). Conclusions The iliac articular surface of the sacroiliac joint is blurred, the erosion, destruction, cystic degeneration and osteopetrosis are the early signs of AS. CT shows more clearly the lesion details more sensitive to early lesions.