国际医学放射学杂志2024，Vol.47Issue(5)：519-526,8.DOI:10.19300/j.2024.L21604
强直性脊柱炎中轴骨病变的影像特征分析
Imaging features of axial bone lesions in ankylosing spondylitis
摘要
Abstract
Objective To summarize the imaging features of axial bone lesions in ankylosing spondylitis(AS),analyze the injury characteristics and imaging manifestations of spinal fractures in patients with AS,and improve the understanding of the disease.Methods A retrospective analysis was conducted on the X-ray,CT,and MRI imaging data of 88 clinically diagnosed AS patients.Sacroiliac joint lesions,spinal lesions,and associated spinal fractures were observed,and the affected locations and number of lesions were recorded.The detection rates of different grades of sacroiliac joint lesions were compared between X-ray and CT imaging,and the detection rates of bone erosion,sclerosis,and joint space changes between CT and MRI were calculated.Thex2 test was used to compare differences in detection rates.Results Of the 88 patients,87(98.86％)had sacroiliac joint involvement.X-ray and CT images showed bilateral sacroiliac joint surface roughness,erosive destruction,marginal sclerosis,joint space widening or narrowing,and partial fusion or complete bony ankylosis of the sacroiliac joints.MRI of the sacroiliac joint was performed on 27 patients,and most showed bone erosion,bone marrow edema,fat deposition,and sclerosis.A few cases exhibited synovitis of the joint space,sacroiliac bursitis,enthesitis,or sacroiliac joint ankylosis with disappearance of the joint space.X-ray detection rates for grade Ⅰ lesions were higher than CT,but lower for grade Ⅱ lesions(both P＜0.05).CT had a higher detection rate for subchondral sclerosis compared to MRI(P＜0.05).Sixty-five patients(73.86％)had spinal involvement,including 38 cases of spinal ankylosis.Twenty-four patients had spondylitis at vertebral corners(Romanus lesions),predominantly in the thoracolumbar and lumbar regions.Fifteen patients had intervertebral discitis(Andersson lesions),mainly affecting the mid-lower thoracic and lumbar vertebrae.Spinal fractures were observed in 24 patients(27.27％),14 had acute fractures,most commonly in the lower cervical spine(C5-7,8 cases),while 10 had old fractures,all located in the thoracolumbar spine(most frequently T11-12,3 cases).Conclusion The imaging manifestations of axial bone lesions in AS have certain characteristics.Spinal fractures in AS patients often involve the three columns of the spine and are prone to spinal cord injury and pseudarthrosis,which requires special attention.关键词
强直性脊柱炎/脊柱关节炎/骶髂关节炎/脊柱骨折/体层摄影术,X线计算机/磁共振成像Key words
Ankylosing spondylitis/Spondyloarthritis/Sacroiliitis/Spinal fracture/Tomography,X-ray computed/Magnetic resonance imaging分类
医药卫生引用本文复制引用
于静红,孙瑞芬,翟伟星,焦洋..强直性脊柱炎中轴骨病变的影像特征分析[J].国际医学放射学杂志,2024,47(5):519-526,8.基金项目
国家自然科学基金地区项目(82360339) （82360339）
内蒙古自然科学基金项目(2021MS08084) （2021MS08084）
内蒙古科技计划项目(2021GG0192) （2021GG0192）
内蒙古医科大学学科建设项目(YKD2023XK006) （YKD2023XK006）
