【摘要】 目的:研究活动性强直性脊柱炎(active ankylosing spondylitis,AAS)MRI诊断方法。方法:临床拟诊可能为AAS而平片骶髂关节(sacroiliac joint,SIJ)检查阴性患者48例行SIJ MRI检查,21例MRI诊断为活动性骶髂关节炎者终止检查,27例MRI不能诊断为活动性骶髂关节炎者加做胸椎MRI检查。综合文献设定AAS SIJ和/或胸椎MRI诊断标准并做出诊断。追踪患者半年并临床确诊。计数单纯SIJ与SIJ和/或胸椎MRI检查对AAS的诊断灵敏度与特异度。结果:48例平片骶髂关节炎阴性患者最终临床综合确诊AAS38例,单纯SIJ检查灵敏度52.6%,特异度90%。SIJ和/或胸椎MRI检查灵敏度76.3%,特异度90%。结论:SIJ MRI阴性且临床可能AAS患者加做胸椎MRI检查能提高AAS的诊断灵敏度。更多还原

【Abstract】 Objective:To diagnoze active ankylosing spondylitis(AAS) by magnetic resonance imaging(MRI).Methods:MRI of the sacroiliac joint(SIJ) was performed on 48 patients who were clinically diagnosed as probable AS without radiologic evidence of sacroiliitis.Among them 21 were diagnozed as active sacroiliitis with MRI,whose examination was terminated;27 whose MRI of SIJ did not diagnoze as active sacroiliitis were performed MRI in the thoracic spine.The diagnostic criteria of MRI for AAS of SIJ and/or the thoracic spine were fomulated by consulting documents.The definite diagnosis of AAS was finally made after follow-up for half a year.The sensitivity and specificity of the MRI of SIJ and/or MRI of thoracic spine were assessed.Results:In the 48 patients without radiologic evidence of sacroiliitis,38 were finally diagnosed as AAS,with established consensus criteria as reference standard.The sensitivity and specificity of the MRI of SIJ were 52.6% and 90.0%,and for the MRI of SIJ and/or the MRI of the thoracic spine 76.3% and 90.0%,respectively.Conclusion:Clinically probable AS without MRI evidence of sacroiliitis,MRI of the thoracic spine can increase the sensitivity of AAS diagnosis.更多还原