摘要
目的:探讨X线、CT及MRI等影像学技术在强直性脊柱炎(ankylosing spondylitis,AS)髋关节病变患者临床诊断中的应用价值。方法:2014年1月至2015年12月对180例AS患者分别行X线、CT及MRI检查,观察AS患者髋关节病变发生情况、3种影像学技术诊断效果及临床特征。结果:AS髋关节病变患者在X线、CT及MRI中的阳性率分别为69.44%、71.11%、72.22%,90%以上为双侧髋关节同时病变。AS髋关节病变影像学特征主要表现为骨髓及关节间隙改变,且与患者病程有密切的关系。X线、CT、MRI诊断中最早出现的阳性征象分别为关节间隙内侧狭窄、关节间隙后部狭窄、骨髓脂肪沉积(bone marrow fat deposition,BMFD)、骨髓水肿(bone marrow edema,BME)。结论:3种影像学技术诊断AS髋关节病变各有优势,X线平片能早期诊断关节间局限性狭窄,但对软骨组织及细微结构显示不及CT及MRI,CT能清晰观察髋关节细微结构,但对软组织分辨力不及MRI,而MRI对软组织辨别率最高,能观察到X线及CT无法显示的BMFD、BME等征象。
Objective To study the diagnostic values of X-ray, CT and MRI for the hip joint lesion of the patient with ankylosing spondylitis（AS）. Methods Totally 180 AS patients underwent the examinations of X-ray, CT and MRI from January 2014 to December 2015, and the hip joint lesion, clinical features and the efficacies of the three imaging techniques were observed. Results The rates for positive findings were 69.44%, 71.11% and 72.22% respectively by X-ray, CT and MRI, and more than 90% patients had the lesions occurred at the bilateral hip joints simultaneously. Hip joint lesion of AS had the imaging features of bone marrow and joint space changes, which related to the disease progress closely. Early positive signs consisted of medial joint space narrowing by X-ray, rear joint space narrowing by CT as well as bone marrow fat deposition（BMFD） and bone marrow edema（BME） by MRI. Conclusion X ray, CT and MRI all gain their advantages when used to diagnose the hip joint lesion of AS. X-ray behaves well in early diagnosis of medial joint space narrowing, while have disadvantages in displaying soft tissues and minute structures when compared with CT and MRI. CT displays the minute structure of hip joint clearly, and is not so good at soft tissue resolution as MRI. MRI gains the highest resolution for displaying soft tissues in the three techniques, and can show BMFD, BME and etc which can not be revealed by X-ray and CT.
出处
《医疗卫生装备》
CAS
2017年第7期59-62,共4页
Chinese Medical Equipment Journal
