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目的 分析X线、CT和MRI在早期强直性脊柱炎骶髂关节病变诊断中的的诊断价值.方法 选用120例强直性脊柱炎骶髂关节病变患者作为研究对象,对所有患者先后采用X线、CT和MRI检查,根据诊断结果分析三种诊断方法的诊断价值.结果 除骨质侵蚀和骨质囊变外(x2 =8.179、6.289,均P<0.05),CT和MRI检查诊断的准确性差异无统计学意义(P>0.05);对关节软骨肿胀、关节间隙狭窄、关节间隙增宽、关节面侵蚀、关节面骨质囊变、关节面下骨质硬化的X线检出率分别为0.83%、16.67%、59.17%、64.17%、34.17%、55.00%,CT的检出率分别为7.50%、31.67%、70.00%、85.00%、69.17%、70.83%,MRI的检出率分别为11.67%、32.50%、70.83%、96.67%、84.17%、71.67%,除关节间隙增宽外(x2 =6.138、6.757,均P>0.05),CT、MRI检查诊断准确率均高于X线检查,差异均有统计学意义(x2 =5.572、10.027、2.563、2.988、11.444、33.539、24.527、51.740、5.370、5.983,均P<0.05).结论 X线检查的诊断准确率低,漏诊率高.CT和MRI在早期强直性脊柱炎骶髂关节病变诊断中的的诊断准确率高,适合作为早期诊断的常用诊断方法.

Objective To compare the diagnostic value of X-ray,CT or MRI in detection of abnormal sacroiliac joint changes in patients with early stage ankylosing spondylitis.Methods One hundred and twenty patients with early stage ankylosing spondylitis who admitted in our hospital underwent X-ray,CT and MRI subsequently were selected,and the diagnostic value was analyzed.Results There were no statistically significant differences in diagnostic accuracy of articular cartilage swelling,joint space narrowing,joint space widening,the articular surface of cystic mass,articular sclerosis by CT and MRI(all P>0.05),except for bone erosion and bone cyst lesion(x2 =8.179,6.289,all P<0.05).The detection rates of articular cartilage swelling,joint space narrowing,joint space widening,articular erosion,the articular surface of cystic mass,and articular sclerosis by X-ray were 0.83%,16.67%,59.17%,64.17%,34.17%,55% respectively,which by CT were 7.50%,31.67%,70.00%,85.00%,69.17%,70.83% respectively,which by MRI were 11.67%,32.50%,70.83%,96.67%,84.17.00%,71.67% respectively.There was statistical difference in the diagnostic accuracy of all measurements among CT,MRI and X-ray(x2=5.572,10.027,2.563,2.988,11.444,33.539,24.527,51.740,5.370,5.983,all P<0.05) except for joint space widening(x2 =6.138,6.757,all P>0.05).Conclusion X-ray associated with low accuracy rate and high rate of miss diagnosis.With the high accuracy rate in detection of abnormal sacroiliac joint changes in patients with early stage ankylosing spondylitis,both CT and MRI are candidate for commonly used diagnostic methods for early diagnosis.