临床研究强直性脊柱炎骨盆骨髓脂肪沉积的磁共振.PDFVIP

·256 · doi 10.3969/j.issn. 1673-4254.2014.02.23 J South Med Univ, 2014, 34(2): 256-259 临床研究 强直性脊柱炎骨盆骨髓脂肪沉积的磁共振成像分析强直性脊柱炎骨盆骨髓脂肪沉积的磁共振成像分析 陈芳妮，李绍林，张晓东，陈焱君，胡绍勇，赵银霞 南方医科大学第三附属医院医学影像中心，广东 广州 510630 摘要：目的通过分析强直性脊柱炎（AS ）患者骨盆骨髓脂肪沉积（BMFD）的MRI 表现及其分布特点，评估骨盆BMFD 对AS 的 诊断价值。方法 选取88例患者行骨盆MRI 检查，其中44 例经临床确诊的AS 患者作为病例组，44 例经临床确诊的非AS 患者为 对照组。分别比较两组患者双侧骶髂关节及髋臼BMFD 的发生率、病例组骨盆关节与非关节部位BMFD 的分布特点。病例组双 侧骶髂关节炎及髋关节炎不同阶段BMFD 的发生率有无差异。结果 病例组双侧骶髂关节、髋臼BMFD 的发生率显著高于对照 组（P0.01）；关节面下松质骨BMFD 的发生率明显高于非关节部位（P0.01）；骶髂关节早期BMFD 的发生率为40.0%~45.9% ，晚 期病变BMFD 的发生率为58.3%~73.1% ，晚期明显高于早期（P0.01）；髋臼各期病变之间BMFD 发生率的差异无统计学意义 （P0.01）。结论 骨盆MRI 显示BMFD 在AS 患者中发生率较高，主要分布于关节面下，可发生于AS 病变的全过程，提示BMFD 是AS 骨髓病理改变的重要征象，很有可能成为早期诊断AS 的重要依据。 关键词：强直性脊柱炎；骨髓脂肪沉积；骨盆；骶髂关节；髋臼；磁共振成像 Magnetic resonance imaging for pelvic bone marrow fat deposition in patients with ankylosing spondylitis CHEN Fangni, LI Shaolin, ZHANG Xiaodong, CHEN Yanjun, HU Shaoyong, ZHAO Yinxia Medical Image Center, Third Affiliated Hospital of Southern Medical University, Guangzhou 510630, China Abstract: Objective To evaluate the diagnostic value of pelvis bone marrow fat depositions (BMFD) displayed by magnetic resonance imaging (MRI) in patients with ankylosing spondylitis (AS). Methods Eighty-eight subjects undergoing pelvic MRI examinations were enrolled in this study, including 44 with clinically confirmed AS (39 male and 5 female patients with a mean age of 26.41±8.09 years) and 44 control subjects without AS (37 male and 7 female subjects with a mean age of 29.32±7.31 years). The incidence of BMFD in the bilateral sacroiliac (SI) joints and acetabulums were compared between the two groups. The distribution features of BMFD of the periarticular cancellous bone marrow in the pelvis and in other regions of the pelvis were analyzed for the AS patients, and