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目的 探讨CT扫描对强直性脊柱炎 (AS)骶髂关节病变的诊断价值及年龄特征对CT表现的影响。方法 收集 780例根据临床表现和 /或实验室检查疑诊AS ,并且骶髂关节的X线及CT资料完整者为研究对象。分别参照X线及CT片对其进行了分级和征象统计 ,并以 <40岁 (第 1组 5 13例 )和≥ 40岁 (第 2组 2 6 7例 )将其分为两组 ,进行组间分级及CT表现差异的比较。结果 本组X线诊断为 0～Ⅳ级骶髂关节病变的各组中 ,CT结果与之符合的比率分别为 44 %、35 %、49%、71%和 77%。根据CT所示可以分别将 5 6 %、2 9%、33%X线平片诊断正常及Ⅰ、Ⅱ级病变的病例提高 1～ 2个诊断级别。第 1组 0～Ⅰ级所占比率明显高于第 2组 ,而Ⅱ级比率则远低于第 2组。第 1组骨性关节面硬化、模糊的发生率明显低于第 2组。结论 CT扫描对AS骶髂关节病变的诊断具有重要价值。CT与平片的区别在于细微征象的显示率高 ,对较早期的病变可以提高诊断等级 ,同时也有利于对治疗效果的观察。本研究的分组分析结果提示在对骶髂关节的CT片进行分析时亦应将年龄因素导致的退行性表现考虑在内
Objective To investigate the diagnostic value of CT scan in the diagnosis of sacroiliac joint disease in ankylosing spondylitis (AS) and the effect of age characteristics on CT findings. Methods A total of 780 cases of suspected AS diagnosed according to clinical manifestations and / or laboratory tests were collected, and the complete X-ray and CT data of sacroiliac joint were collected. The patients were divided into two groups according to the grade and the signs of X-ray and CT. The patients were divided into two groups (<40 years old (51 cases in group 1) and ≥40 years old (267 cases in group 2) Comparison of grading and CT findings among groups. Results In this group, the results of X-ray diagnosis of sacroiliac joint lesions of grade 0 ~ IV were 44%, 35%, 49%, 71% and 77% respectively. According to the CT, 56 cases, 29%, 33% of X-ray films were diagnosed as normal and grade Ⅰ and Ⅱ of the cases increased by 1 to 2 diagnostic levels. The first group of 0 ~ Ⅰ rate was significantly higher than the second group, while the second level rate is much lower than the second group. The first group of osteoarticular sclerosis, the incidence of blur was significantly lower than the second group. Conclusion CT scan is of great value in the diagnosis of AS sacroiliac joint disease. The difference between CT and plain film is that the display rate of fine signs is high, the diagnosis level can be improved for earlier lesions, and the observation of the therapeutic effect is also beneficial. The group analysis of the present study suggests that age-related degenerative manifestations should also be taken into account when analyzing CT slices of sacroiliac joints