Department of Ultrasound in Medicine, Shanghai Jiaotong University Affiliated Sixth People's Hospital, 600 Yishan Rd, Shanghai 200233, China.
Rheumatol Int. 2012 Jan;32(1):69-72. doi: 10.1007/s00296-010-1543-x. Epub 2010 Jul 25.
To investigate the complex appearance of vascularity of sacroiliac joint (SIJ) in ankylosing spondylitis. Sixty-eight patients and 35 controls were included in the study. Blood flow was examined at the SIJ by using color Doppler ultrasonography (CDUS). The location of color flow signs and flow pattern were observed. Arteries do not present reversed phase in diastolic phase on pulse Doppler sonography, and if they were found inside and around the SIJ, the resistive index (RI) was measured. In active AS patients, the region of SIJ presented increased vascularization greater than those in inactive AS (P = 0.001) and the controls (P = 0.001). There are three different spectral Doppler tracings: arterial flow (RI < 1), arterial flow representing reversed phase in diastolic phase on spectral Doppler sonography and venous flow. Besides arterial flow signs, most of color flow signs presented venous flow in active AS. Significant increases in a number of venous flow signs in active AS cases (P < 0.001) were observed. In most cases, two or more different flow patterns presented in a region very close to the location of SIJ. In addition, a different vascularization was observed. Abnormal vascularization at the sacroiliac joints can be detected by CDUS. The vascularization in SIJ presented complex appearance, which increases the difficulties of CDUS examination. Venous blood flow in the assessment of active AS merits further study.
探讨强直性脊柱炎（AS）患者骶髂关节（SIJ）血管复杂表现。本研究纳入 68 例患者和 35 例对照。采用彩色多普勒超声（CDUS）检查 SIJ 血流。观察血流信号位置和血流模式。脉冲多普勒超声显示动脉在舒张期无反向血流，如果在 SIJ 内及周围发现动脉，则测量阻力指数（RI）。在活动期 AS 患者中，SIJ 区域的血管化程度高于非活动期 AS（P = 0.001）和对照组（P = 0.001）。有三种不同的频谱多普勒描记：动脉血流（RI < 1）、频谱多普勒超声显示舒张期反向血流的动脉血流和静脉血流。除了动脉血流信号外，大多数活动期 AS 的彩色血流信号也表现为静脉血流。活动期 AS 患者的静脉血流信号数量显著增加（P < 0.001）。在大多数情况下，同一区域可以出现两种或两种以上不同的血流模式。此外，还观察到不同的血管化。CDUS 可检测到骶髂关节的异常血管化。SIJ 的血管化呈现出复杂的表现，增加了 CDUS 检查的难度。静脉血流在评估活动期 AS 中的作用值得进一步研究。
