低场MRI联合放射影像学检查诊断早期强直性脊柱炎患者骶髂关节病变的效能及对骨代谢指标的影响

胡英

【摘要】 目的：研究低場MRI联合放射影像学检查诊断早期强直性脊柱炎骶髂关节病变的效能及对骨代谢指标的影响。方法：回顾性分析2015年5月-2020年5月在本院接受治疗检查的80例早期强直性脊柱炎骶髂关节病变患者的临床资料，所有患者均接受低场MRI、CT及X线检查，比较不同检查方式的结果差异并分析早期骨代谢指标。结果：联合检查的检出率均高于X线、CT、低场MRI单独检查，差异均有统计学意义（P<0.05）。0～Ⅳ级单独检查患者关节等级诊出率少于联合检查。X线、CT、低场MRI诊断患者关节等级与联合检查比较，差异均有统计学意义（P<0.05）。不同关节状况患者的腰椎、股骨颈、Word’s三角区、股骨粗隆的骨密度比较，差异均有统计学意义（P<0.05）。不同关节状况患者的BGP、PTH、BALP、CICP、尿DPD、CTX比较，差异均有统计学意义（P<0.05）。随着病变等级的增加，骨密度、BGP、PTH、BALP均降低，CICP、尿DPD、CTX均升高。结论：低场MRI联合放射影像学检查在早期强直性脊柱炎骶髂关节病变中具有重要作用，能有效提升患者病变检出情况，判断早期骨代谢指标，指导临床治疗，具有较高的临床应用价值。

【关键词】 低场MRI 放射影像学检查 早期强直性脊柱炎骶髂关节病变 骨代谢指标

Efficacy of Low-field MRI Combined with Radiographic Examination in the Diagnosis of Early Ankylose Spondylitis Sacroiliac Joint Lesions and Its Influence on Bone Metabolism Indicators/HU Ying. //Medical Innovation of China， 2021， 18（31）： -133

[Abstract] Objective： To explore efficacy of low-field MRI combined with radiographic examination in the diagnosis of early ankylose spondylitis sacroiliac joint lesions and its influence on bone metabolism indicators. Method： The clinical data of 80 patients with early ankylose spondylitis sacroiliac joint lesions who received treatment examination in our hospital from May 2015 to May 2020 were retrospectively analyzed. All patients received low-field MRI， CT and X-ray examination， the differences of the results of different examination methods were compared and the early bone metabolism indicators were analyzed. Result： The detection rate of combined examination was higher than that of X-ray， CT and low-field MRI alone， and the differences were statistically significant （P<0.05）. The rates of joint grade diagnosis in patients with grade 0-Ⅳ alone were less than those in combined examination. There were statistically significant differences in joint grade between patients diagnosed by X-ray， CT and low-field MRI and combined examination （P<0.05）. There were significant differences in BMD of lumbar spine， femoral neck， Word’s trigone and femoral trochanter in patients with different joint conditions （P<0.05）. There were statistically significant differences in BGP， PTH， BALP， CICP， urinary DPD and CTX in patients with different joint conditions （P<0.05）. Bone mineral density， BGP， PTH and BALP were decreased with the increase of lesion grade， while CICP， urinary DPD and CTX were increased with the increase of lesion grade. Conclusion： Low-field MRI combined with radiographic examination plays an important role in early ankylose spondylitis sacroiliac joint lesions， which can effectively improve the detection of the patient’s lesions， determine early bone metabolism indicators， and guide clinical treatment. It has high clinical application value.

[Key words] Low-field MRI Radiographic examination Early ankylosing spondylitis sacroiliac joint lesions Bone metabolism indicators

First-author’s address： Songzi City Hospital of Traditional Chinese Medicine， Songzi 434200， China

doi：10.3969/j.issn.1674-4985.2021.31.031

强直性脊柱炎是一种临床上较为常见的慢性进行性疾病，其主要附着点和发病部位包括骶髂关节和脊柱，目前临床研究发现其发病与人体白细胞抗原存在较为紧密的关系，为血清阴性脊柱关节病变，在发病初期通常无明确的临床表现，因而往往容易被忽略，进而导致患者病情未能得到有效控制，耽误患者的治疗时机[1-2]。……