【摘要】 目的 研究超声在活动期强直性脊柱炎(ankylosing spondylitis, AS)骶髂关节血流中的评估价值，以提高患者的接受度及诊疗水平。方法 选择本院2020年5月～2021年5月收治的40例活动期AS患者作为研究组，40例体检健康者作为对照组，两组各左右80个骶髂关节，均采取彩色多普勒超声(color doppler ultrasound, CDUS)检查。比较两组的骶髂关节血流特点，并以MRI检查结果为金标准，分析CDUS对患者骶髂关节血流的敏感度、特异度、准确率。结果 研究组的血流分级、血流显示比例、静脉血流比例、动脉血流比例、舒张期正相血流比例、舒张期反相血流比例显著高于对照组，研究组的RI显著低于对照组，差异均有统计学意义(P<0.05)。以MRI为准，CDUS检查患者骶髂关节血流的敏感度为90.57%,特异度为88.89%,准确率为88.89%,经Kappa检验分析，K值为0.85,表示CDUS、MRI评估骶髂关节血流的一致性较好。结论 超声能够有效显示活动期AS骶髂关节血流特点，且灵敏度、特异度与准确率较高，可适当作为MRI的替代手段，为临床诊疗提供可靠依据。更多还原

【Abstract】 Objective To study the clinical value of ultrasound in the evaluation of sacroiliac joint blood flow in active ankylosing spondylitis(AS), so as to improve the acceptance and diagnosis and treatment level of patients. Methods Forty patients with AS in our hospital in active period from May 2020 to May 2021 were selected as the study group, and 40 healthy persons were selected as the control group. Color Doppler ultrasound(CDUS) was performed on in 80 sacroiliac joints in both two groups. The blood flow characteristics of sacroiliac joint were compared between the two groups, and the results of MRI were taken as the gold standard. The sensitivity, specificity and accuracy of CDUS on sacroiliac joint blood flow were analyzed. Results The blood flow grade, blood flow display ratio, venous blood flow ratio, arterial blood flow ratio, diastolic positive blood flow ratio and diastolic reversed blood flow ratio in the study group were significantly higher than those in the control group, and the RI in the study group was significantly lower than that in the control group(P<0.05). Based on MRI, the sensitivity, specificity and accuracy of CDUS in assessing sacroiliac joint blood flow were 90.57%, 88.89% and 88.89%. According to Kappa test, the K value was 0.85, indicated that CDUS and MRI had good consistency in assessing sacroiliac joint blood flow. Conclusion Ultrasound can effectively display the blood flow characteristics of sacroiliac joint in active AS, and has high sensitivity, specificity and accuracy. It can be appropriately used as an alternative of MRI to provide a reliable basis for clinical diagnosis and treatment.更多还原