中国实用医刊
中國實用醫刊
중국실용의간
CENTRAL PLAINS MEDICAL JOURNAL
2012年
20期
49-52
,共4页
强直性脊柱炎%骶髂关节%体层摄影术%X线计算机%早期诊断
彊直性脊柱炎%骶髂關節%體層攝影術%X線計算機%早期診斷
강직성척주염%저가관절%체층섭영술%X선계산궤%조기진단
Ankylosing spondylitis%Sacroiliac joint%Tomography%X-ray computerd%Early diagnosis
目的 探讨多层螺旋CT(MSCT)多平面重组(MPR)技术和曲面重组(CPR)技术在强直性脊柱炎(AS)骶髂关节病变中的诊断价值.方法 对56例临床确诊的AS患者进行双侧骶髂关节MSCT容积扫描获得原始横断面图像,并进行MPR获得双侧骶髂关节矢状面和冠状面图像,然后选取矢状面图像分别在骶骨上缘1/4、1/2、3/4处沿骶骨走行划曲线进行CPR技术获得双侧骶髂关节成像.分别对横断面图像、MPR图像和CPR图像进行比较分析.结果 AS患者CT表现特点为病变主要累及骶髂关节滑膜部的髂骨侧,早期CT表现为关节面毛糙、关节面皮质中断或白线消失,软骨下骨质受侵蚀、囊变,关节面轻度硬化,但关节间隙无改变.进展期主要表现为关节面不光整、局部骨皮质呈锯齿状改变,软骨下骨质囊状破坏、骨质硬化明显,关节间隙增宽.稳定期主要表现为关节骨性强直、关节间隙消失,骶髂韧带钙化.56例AS患者,双侧同时受累47例,单侧受累9例；轴位图像诊断,Ⅰ～Ⅱ级16例,Ⅲ～Ⅳ级25例；MPR图像诊断Ⅰ～Ⅱ级24例,Ⅲ～Ⅳ级26例;CPR图像诊断Ⅰ～Ⅱ级29例,Ⅲ～Ⅳ级26例,早期诊断率轴位图像与重建图像比较差异有统计学意义(P＜0.05),晚期诊断率比较差异无统计学意义(P＞0.05).结论 多层螺旋CT和后处理MPR图像和CPR图像对强直性脊柱炎骶髂关节病变中的诊断有重要价值,特别是CPR图像能全面观察骶髂关节,对强直性脊柱炎骶髂关节病变的早期诊断更有意义.
目的 探討多層螺鏇CT(MSCT)多平麵重組(MPR)技術和麯麵重組(CPR)技術在彊直性脊柱炎(AS)骶髂關節病變中的診斷價值.方法 對56例臨床確診的AS患者進行雙側骶髂關節MSCT容積掃描穫得原始橫斷麵圖像,併進行MPR穫得雙側骶髂關節矢狀麵和冠狀麵圖像,然後選取矢狀麵圖像分彆在骶骨上緣1/4、1/2、3/4處沿骶骨走行劃麯線進行CPR技術穫得雙側骶髂關節成像.分彆對橫斷麵圖像、MPR圖像和CPR圖像進行比較分析.結果 AS患者CT錶現特點為病變主要纍及骶髂關節滑膜部的髂骨側,早期CT錶現為關節麵毛糙、關節麵皮質中斷或白線消失,軟骨下骨質受侵蝕、囊變,關節麵輕度硬化,但關節間隙無改變.進展期主要錶現為關節麵不光整、跼部骨皮質呈鋸齒狀改變,軟骨下骨質囊狀破壞、骨質硬化明顯,關節間隙增寬.穩定期主要錶現為關節骨性彊直、關節間隙消失,骶髂韌帶鈣化.56例AS患者,雙側同時受纍47例,單側受纍9例；軸位圖像診斷,Ⅰ～Ⅱ級16例,Ⅲ～Ⅳ級25例；MPR圖像診斷Ⅰ～Ⅱ級24例,Ⅲ～Ⅳ級26例;CPR圖像診斷Ⅰ～Ⅱ級29例,Ⅲ～Ⅳ級26例,早期診斷率軸位圖像與重建圖像比較差異有統計學意義(P＜0.05),晚期診斷率比較差異無統計學意義(P＞0.05).結論 多層螺鏇CT和後處理MPR圖像和CPR圖像對彊直性脊柱炎骶髂關節病變中的診斷有重要價值,特彆是CPR圖像能全麵觀察骶髂關節,對彊直性脊柱炎骶髂關節病變的早期診斷更有意義.
목적 탐토다층라선CT(MSCT)다평면중조(MPR)기술화곡면중조(CPR)기술재강직성척주염(AS)저가관절병변중적진단개치.방법 대56례림상학진적AS환자진행쌍측저가관절MSCT용적소묘획득원시횡단면도상,병진행MPR획득쌍측저가관절시상면화관상면도상,연후선취시상면도상분별재저골상연1/4、1/2、3/4처연저골주행화곡선진행CPR기술획득쌍측저가관절성상.분별대횡단면도상、MPR도상화CPR도상진행비교분석.결과 AS환자CT표현특점위병변주요루급저가관절활막부적가골측,조기CT표현위관절면모조、관절면피질중단혹백선소실,연골하골질수침식、낭변,관절면경도경화,단관절간극무개변.진전기주요표현위관절면불광정、국부골피질정거치상개변,연골하골질낭상파배、골질경화명현,관절간극증관.은정기주요표현위관절골성강직、관절간극소실,저가인대개화.56례AS환자,쌍측동시수루47례,단측수루9례；축위도상진단,Ⅰ～Ⅱ급16례,Ⅲ～Ⅳ급25례；MPR도상진단Ⅰ～Ⅱ급24례,Ⅲ～Ⅳ급26례;CPR도상진단Ⅰ～Ⅱ급29례,Ⅲ～Ⅳ급26례,조기진단솔축위도상여중건도상비교차이유통계학의의(P＜0.05),만기진단솔비교차이무통계학의의(P＞0.05).결론 다층라선CT화후처리MPR도상화CPR도상대강직성척주염저가관절병변중적진단유중요개치,특별시CPR도상능전면관찰저가관절,대강직성척주염저가관절병변적조기진단경유의의.
Objective To investigate the diagnostic value of multi-slice spiral CT(MSCT) and its multi-planar reconstruction(MPR) and curved planar reconstruction(CPR) on sacroiliac joint with ankylosing spondylitis(AS).Methods Fifty-six patients with AS proved clinically were examined and analyzed with MSCT and reconstruction.Then the CT manifestations of sacroiliace joints were analyzed.And choose a sagittal image respectively in the margin of the sacrum one-four,one-second and two-four.Then went down the sacrum line trace for CPR technique get double sided sacroiliac joint imaging.The images,MPR transect images and CPR image were analyed.Results Early CT findings included coarsearticular surface,interrupted jiont cortex,vague articular face,subcortical microcysts and sclerotic articular surface,while jiont space was normal.CT findings in progressive stage were uneven articular surface,damaged bony cortex,subcartilaginous bone microcyats,obviously sclerotic articular surface,extended jiontspace.In stable stage,CT findings included joint ankylosis,articular space dsiappearance,and sacroiliac ligament calcification.Fifty-six cases of AS patients,bilateral simultaneous involvement in 47 cases,unilateral involvement in 9 cases,axial image diagnosis,Ⅰ-Ⅱ grade 16 cases,Ⅲ-Ⅳ grade 26 cases.MPR image diagnosis of Ⅰ-Ⅱ grade 24 cases,Ⅲ-Ⅳ Grade 26 cases,CPR class Ⅰ diagnostic images-Ⅱ grade 29 cases,Ⅲ-Ⅳ grade in 26 cases,early diagnosis of axial images and reconstruction images were significantly different (P ＜ 0.05),the late diagnosis rates were not significantly different (P ＞ 0.05).Conclusions It is valuable to use MPR and CPR images to diagnosis sacroiliac joint lesions in patients with ankylosing spondylitis.Especially CPR image can be used to comprehensively observe sacroiliac joint,and it is more meaningful in early diagnosis of sacroiliac joint lesions in patients with AS.
