CAJ | 학술논문

目的：强直性脊柱炎（ ankylosing spondylitis ， AS）可累及腰椎骨突关节和椎体，文中比较多排螺旋CT和MRI对腰椎骨突关节病变的诊断价值，进而评估骨突关节病变对AS的早期诊断价值。方法回顾性分析41例男性AS患者的影像资料。全部患者行MSCT检查，18例患者行MRI平扫，23例患者行MRI平扫DWI和增强T1WI压脂序列扫描。采用Fisher确切概率检验比较MSCT和MRI对骨突关节病变的检出率，以及对腰椎骨突关节病变与椎体病变的检出率；分析骨突关节病变与病程的关系。结果 MSCT对骨突关节与椎体病变的检出率分别为90．2％、58．5％（P＞0．05），MRI对骨突关节与椎体病变的检出率分别为80．5％、46．3％（P＞0．05）。 MSCT 和MRI对AS骨突关节病变的检出率差异无统计学意义（P＞0．05），对AS椎体病变的检出率差异有统计学意义（P＜0．05）。骨突关节病变可以出现于起病1年内及椎体病变产生之前。结论 MSCT和MRI均能够显示腰椎骨突关节病变；骨突关节病变可出现在AS早期，早于椎体病变，提示该征象有可能成为早期诊断AS的依据。
목적：강직성척주염（ ankylosing spondylitis ， AS）가루급요추골돌관절화추체，문중비교다배라선CT화MRI대요추골돌관절병변적진단개치，진이평고골돌관절병변대AS적조기진단개치。방법회고성분석41례남성AS환자적영상자료。전부환자행MSCT검사，18례환자행MRI평소，23례환자행MRI평소DWI화증강T1WI압지서렬소묘。채용Fisher학절개솔검험비교MSCT화MRI대골돌관절병변적검출솔，이급대요추골돌관절병변여추체병변적검출솔；분석골돌관절병변여병정적관계。결과 MSCT대골돌관절여추체병변적검출솔분별위90．2％、58．5％（P＞0．05），MRI대골돌관절여추체병변적검출솔분별위80．5％、46．3％（P＞0．05）。 MSCT 화MRI대AS골돌관절병변적검출솔차이무통계학의의（P＞0．05），대AS추체병변적검출솔차이유통계학의의（P＜0．05）。골돌관절병변가이출현우기병1년내급추체병변산생지전。결론 MSCT화MRI균능구현시요추골돌관절병변；골돌관절병변가출현재AS조기，조우추체병변，제시해정상유가능성위조기진단AS적의거。
Objective Ankylosing spondylitis (AS) can affect both the lumbar zygapophyseal joint and the centrum .This study was to compare multislice spiral CT ( MSCT) and MRI in the diagnosis of zygapophyseal joint lesions in AS patients and assess the role of zygapophyseal joint lesions in the early diagnosis of AS . Methods We retrospectively analyzed the lumbar imaging data of 41 male patients with AS .Forty-one male AS patients underwent MSCT , 18 receiving normal MRI , and the other 23 diffusion weighted imaging (DWI) and CE-T1WI-STIR in addition.Using Fisher′s Exact Test, we compared MSCT and MRI in their detection rates of a-pophyseal joint lesions and positive changes in the zygapophyseal joint and lumbar centrum .Then we analyzed the relation between the zygapophyseal joint lesions and the disease duration . Results The detection rates of zygapophyseal joint and centrum lesions were 90.2%and 58.5%on MSCT (P>0.05), and 80.5%and 46.3%on MRI (P>0.05), respectively.MSCT and MRI exhibited sig-nificant differences in the detection rate of centrum lesions (P<0.05) but not in that of zygapophyseal joint lesions (P>0.05). These lesions could appear within 1 year after the onset of AS or ahead of vertebral changes . Conclusion Both MSCT and MRI can manifest zygapophyseal joint lesions , which may develop in the lumbar spine at the early stage of AS , ahead of centrum lesions .This is important for the early diagnosis of AS .