摘要
目的观察中轴型血清阴性脊柱关节病(spondyloarthropathy,SpA)患者骶髂关节功能磁共振成像肌及骨质改变情况,分析两者之间的关系。方法采用Siemens aera1.5T磁共振扫描仪,用高通道体表线圈,对符合2009年中轴型血清阴性SpA诊断标准的38例患者进行骶髂关节磁共振扫描,观察肌及骨质改变情况。根据磁共振成像,将入组患者分为肌水肿阳性组及阴性组,对两组患者磁共振图像骨质改变进行影像学评分,包括加拿大脊柱骨关节研究协会评分(SPARCC)以及骶髂关节骨质结构性改变评分(SPARCC SSS)。分析两组间影像评分的统计学差异,将患者骶髂关节周围肌受累范围分为0~12等级,对肌水肿受累范围不同等级与上述指标进行Spearman等级相关性检验。结果38例患者中28例(73.68%)患者具有明显肌水肿,竖脊肌22例(57.89%),臀肌13例(34.21%),髂肌11例(28.95%),闭孔内肌5例(13.16%),梨状肌5例(13.16%),其他4例(10.53%)。患者均有不同程度骨髓水肿及结构性改变;肌水肿阳性组及阴性组两组间SPARCC(t=2.28,P=0.03)、SPARCC SSS(t=3.37,P=0.00)差异均有统计学意义。SPARCC(P=0.00,r=0.67)、SPARCC SSS(P=0.01,r=0.47)均与肌水肿受累范围存在正相关。结论骶髂关节周围肌水肿为中轴型血清阴性SpA磁共振检查的重要征象,伴有肌炎性水肿者骨质改变更严重。
Objective To observe the muscles and skeleton involvement surrounding sacroiliac joint （SIJ） of axial seronegative spondyloarthropathy （SpA） patients with magnetic resonance imaging （MRI）, and to analyze the relationship between them. Methods A prospective study of 38 patients who meet the 2009 axial SpA diagnostic criteria was conducted. We carried out MRI of the SIJ for these patients to evaluate the muscles and skeleton involvement. Those cases were divided into muscles differences between the two groups of image scores, including Spondyloarthritis Research Consortium of Canada （SPARCC） scores and Spondyloarthritis Research Consortium of Canada MRI Sacroiliac Joint Structural Score （SPARCC SSS）. The extent of muscles edema in patients with sacroiliac joints was ranked into twelve grades from 0-12, and we did Spearman rank correlation test of muscles edema scope and two indexes. Results We found that 28 cases （73.68%） of the 38 patients had significant muscle involvement by analyzing the STIR sequence, and found erector spinae in 22 cases （57.89%） gluteal muscles in 13 cases （34.21%）, iliacus muscle in 11 cases （28.95%）, obturator muscle in 5 cases （13.16%）, piriform muscle in 5 cases （13.16%） and other 4 cases （10.53%）. SPARCC （t=2.28, P=0.03） and SPARCC SSS （t=3.37, P=0.00） were statistically different between the two groups. SPARCC （P=0.00, r=0.67） and SPARCC SSS （P=0.01, r=0.47） were positively correlated with the extent of muscles edema. Conclusions The muscles edema around sacroiliac joint is an important sign of axial SpA magnetic resonance imaging. Patients who had muscles edema tended to have more serious skeleton changes.
出处
《复旦学报（医学版）》
CAS
CSCD
北大核心
2017年第2期168-174,共7页
Fudan University Journal of Medical Sciences
关键词
脊柱关节病
磁共振成像
水肿/肌
骨质
spondyloarthritis magnetic resonance imaging edema/muscles skeleton
