Braun J, Rudwaleit M, Hermann K G, Rau R
Rheumazentrum Ruhrgebiet, Landgrafenstrasse 15, 44652 Herne.
Z Rheumatol. 2007 Mar;66(2):167-78. doi: 10.1007/s00393-006-0108-6.
In addition to the typical clinical symptoms, conventional x-rays and magnetic resonance imaging (MRI) are important for the diagnosis and management of ankylosing spondylitis (AS). While radiography is mainly useful for detecting chronic structural changes, MRI is, in addition, able to detect active inflammation. The detection of structural changes in the sacroiliac joints and, in part, the spine, remains the gold standard for the diagnosis of AS. The detection of active sacroiliitis or spondylitis in early disease stages is only possible using MR techniques such as STIR and T1 post-gadolinium sequences. Lateral radiographs of the spine are useful for detecting shiny corners and the characteristic syndesmophytes and ankylosis. The modified Stoke Anklyosing Spondylitis Spine Score (SASSS) is the best scoring method for quantifying such changes, allthough only the cervical and the lumber spine are evaluated with this method. MRI changes can also be quantified. New scoring methods are sensitive to change only 3 months after initiation of therapy with anti-TNF agents.
除了典型的临床症状外，传统X线和磁共振成像（MRI）对强直性脊柱炎（AS）的诊断和治疗很重要。虽然放射摄影主要用于检测慢性结构变化，但MRI还能够检测活动性炎症。骶髂关节以及部分脊柱结构变化的检测仍然是AS诊断的金标准。只有使用诸如短TI反转恢复序列（STIR）和钆增强后T1序列等MR技术，才能在疾病早期检测到活动性骶髂关节炎或脊柱炎。脊柱侧位X线片有助于检测椎体角炎和特征性骨桥及脊柱融合。改良斯托克强直性脊柱炎脊柱评分（SASSS）是量化此类变化的最佳评分方法，不过该方法仅评估颈椎和腰椎。MRI变化也可以量化。新的评分方法在使用抗TNF药物治疗仅3个月后对变化就很敏感。
