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目的:分析和研究对于强直性脊柱炎患者进行有关骶髂关节方面的CT观察。方法:收集我院经临床、影像、实验室明确诊断的AS病例共计12例。所有患者均行双侧骶髂关节CT扫描。CT扫描用SIEMENS SPIRIT螺旋扫描机,层厚5mm,层距5mm,自骶髂关节上缘连续向下扫描至骶髂关节下缘,骨窗摄片观察。结果:根据AS骶髂关节病变分级标准12例患者进行CT分级,结果I级1例,II级4例,III级5例,IV级2例。12例24个骶髂关节有11例23个骶髂关节面呈不同程度的硬化,5例轻度硬化,4例中度硬化,2例重度硬化。II级4例中有3例轻度硬化,1例中度硬化。III级5例中有4例中度硬化,1例重度硬化。IV级2例中有轻度并有骨质疏松。结论:AS骶髂关节病变的早期CT表现是髂骨关节面硬化,密度增高,随病变进展,关节面硬化程度加重,范围扩大,随之有关节侵蚀、破坏,以髂骨关节面侵蚀较多、明显,关节间隙变窄,最后骶髂关节部分以至完全强直。
OBJECTIVE: To analyze and study CT findings in sacroiliac joints in patients with ankylosing spondylitis. Methods: A total of 12 AS cases diagnosed by clinical, imaging and laboratory tests in our hospital were collected. All patients underwent bilateral sacroiliac joint CT scan. CT scanning with SIEMENS SPIRIT spiral scanner, layer thickness 5mm, layer spacing 5mm, continuous scan down from the upper edge of sacroiliac joint to the lower edge of sacroiliac joint, bone window radiography. Results: According to AS grade of sacroiliac joint grading, CT grade was performed in 12 cases. The results were grade I in 1 case, grade II in 4 cases, grade III in 5 cases and grade IV in 2 cases. Of the 12 patients with 24 sacroiliac joints, 11 had 23 sacroiliac joints with varying degrees of sclerosis, 5 with mild sclerosis, 4 with moderate sclerosis, and 2 with severe sclerosis. Three of the 4 patients in grade II had mild sclerosis and 1 patient had moderate sclerosis. In grade III, 4 were moderately sclerosis and 1 was severe. Grade IV in 2 cases with mild and osteoporosis. CONCLUSIONS: The early CT appearance of sacroiliac joint lesions is the iliac articular surface sclerosis with increased density. With the progression of the disease, the degree of articular surface sclerosis is aggravated and the scope is widened. There is also joint erosion and destruction and more erosion of the iliac articular surface , Obviously, narrowing of the joint space, and finally the part of the sacroiliac joint as well as complete rigidity.