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[炎症性脊柱疾病的影像学]

[Imaging in inflammatory spine diseases].

作者信息

Theumann Nicolas, Aubry-Rozier Bérengère, Guntern Daniel

机构信息

Service de radiodiagnostic et radiologie interventionnelle, Département de l'appareil locomoteur CHUV, 1011 Lausanne.

出版信息

Rev Med Suisse. 2009 Mar 11;5(194):566, 568-70.

Abstract

There is a mean delay of 5 to 8 years between the onset of symptoms and the diagnosis of ankylosing spondylitis. This is due to the fact that radiographic sacroiliitis is delayed. The purpose of an earlier diagnosis is emphasized by the need for better management, the new diagnostic method including magnetic resonance imaging and by the efficacy of anti-TNF therapy. The current criteria are classification but not diagnostic criteria. Their sensitivity is insufficient for an early diagnosis of ankylosing spondylitis. MRI criteria allow to differentiate inflammatory signs from degenerative signs in patients sent for aspecific low back pain. The aims of this article are to illustrate the different stages of the disease from early inflammatory involvement to ankylosis and to discuss the role of imaging in the management of affected patients.

摘要

从症状出现到强直性脊柱炎确诊,平均有5至8年的延迟。这是因为骶髂关节的影像学改变出现较晚。更好的治疗管理需求、包括磁共振成像在内的新诊断方法以及抗TNF治疗的疗效都凸显了早期诊断的重要性。目前的标准是分类标准而非诊断标准。它们的敏感性不足以早期诊断强直性脊柱炎。MRI标准有助于区分因非特异性下背痛就诊患者的炎症征象与退变征象。本文旨在阐述从早期炎症累及到关节强直这一疾病的不同阶段,并探讨影像学在受累患者管理中的作用。

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