摘要
目的探讨高分辨CT对强直性脊柱炎骶髂关节炎的早期诊断价值。方法对40例临床拟诊成人型强直性脊柱炎的患者进行常规横断CT扫描及多层螺旋CT薄层高分辨率扫描,分别对骶髂关节炎的CT表现及分级进行分析,并在CT引导下对该组病人进行骶髂关节穿刺活检,将CT结果分别与病理结果相对比。结果40例中病理诊断骶髂关节炎36例,其中常规横断CT扫描诊断骶髂关节炎的35例中,30例诊断正确,准确率85.7%,病变分级为1～2级的病例诊断准确率70.6%,3～4级准确率100%。假阳性5例,假阴性4例;多层螺旋CT薄层高分辨率扫描诊断骶髂关节炎39例中,36例诊断正确,准确率92.3%,病变分级1～2级准确率85.7%,3～4级准确率100%。假阳性2例,假阴性1例。结论多层螺旋CT薄层高分辨率扫描能清晰显示骶髂关节的细微病理变化,有助于强直性脊柱炎的早期诊断及对疾病的分级评估。
[Objective] To explore the early diagnostic value of using high-resolution computed tomography in ankylosing spondyhtis and sacroiliitis. [Methods] 40 cases of imitated adult patients with ankylosing spondylitis underwent routine intersect CT scan and high-resolution lamellar multislice spiral CT scan. The CT images and ranking of sacroiliitis were analyzed respectively, following the CT-guided piqure biopsy on cacroiliac joint. CT result was contrasted with pathology result. [Results] 36 of 40 cases were pathologically diagnosed as sacroiliitis, among them, 30 of 35 cases underwent routine intersect CT scan were correctly diagnosied, accurate rate reached 85.7%. Accurate diagnosis rate of affection ranking 1-2 was 68% while that of ranking 3-4 hit 100%. 5 cases were false positive, 4 cases were false negative; 32 of 34 cases underwent high-resolution lamellar multislice spiral CT scan were correctly diagnosied as sacroiliitis, accurate rate reached 94.1%. Accurate diagnosis rate of affection ranking 1- 2 was 80.7% wihle that of ranking 3-4 hit 100%. 2 cases were false positive, 1 case was false negative. [Conclusions] High-resolution lamellar multislice spiral CT scan can clearly display tiny pathological change of cacroiliac joint, which greatly conduces to early diagnosis of ankylosing spondylitis and ranking evaluation on disease.
出处
《中国现代医学杂志》
CAS
CSCD
北大核心
2006年第22期3468-3470,共3页
China Journal of Modern Medicine
关键词
骶髂关节炎
高分辨率
多层螺旋CT
ankylosing spondylitis
sacroiliitis
high-resolution computed tomography
multislice spiral CT
