Braun J, van der Heijde D
Rheumazentrum Ruhrgebiet, Landgrafenstr. 15, 44652, Herne, Germany.
Best Pract Res Clin Rheumatol. 2002 Sep;16(4):573-604.
Ankylosing spondylitis (AS) is the prototype of the spondyloarthritides (SpA). AS is a disease subset but also a possible outcome of SpA. Early diagnosis of sacroiliitis, the most frequent clinical symptom frequently accompanied by inflammatory back pain and other inflammatory lesions of the spine such as spondylitis and spondylodiscitis, can be visualized early by magnetic resonance imaging (MRI). Spinal inflammation can be demonstrated by MRI using either the fat-saturating short tau inversion recovery (STIR) technique or by application of the contrast agent gadolinium-diethylenetriamine pentaacetic acid (DTPA). This is especially useful in early and active disease, in young women and in children, and for the differential diagnosis of septic sacroiliitis. Because of the efficacy of the novel biological agents directed against tumour necrosis factor-alpha (TNF-alpha) - such as infliximab and etanercept - in SpA there is a need for spinal imaging techniques more sensitive than conventional X-rays. The available scoring tools are reviewed and novel approaches using MRI are presented.
强直性脊柱炎（AS）是脊柱关节炎（SpA）的典型代表。AS是SpA的一个疾病亚组，但也是SpA可能的一种结局。骶髂关节炎的早期诊断可通过磁共振成像（MRI）早期显现，骶髂关节炎是最常见的临床症状，常伴有炎性背痛以及脊柱的其他炎性病变，如脊柱炎和脊椎间盘炎。使用脂肪饱和短反转时间反转恢复（STIR）技术或应用造影剂钆-二乙烯三胺五乙酸（DTPA），MRI可显示脊柱炎症。这在疾病的早期和活动期、年轻女性和儿童以及化脓性骶髂关节炎的鉴别诊断中尤其有用。由于针对肿瘤坏死因子-α（TNF-α）的新型生物制剂，如英夫利昔单抗和依那西普，在SpA治疗中具有疗效，因此需要比传统X线更敏感的脊柱成像技术。本文综述了现有的评分工具，并介绍了使用MRI的新方法。
