Baraliakos X, Braun J
Rheumazentrum Ruhrgebiet Herne, Ruhr Universität Bochum, Landgrafenstr. 15, 44652, Herne, Deutschland.
Z Rheumatol. 2012 Jan;71(1):27-37. doi: 10.1007/s00393-011-0894-3.
The diagnosis of ankylosing spondylitis (AS) is based on the modified New York criteria and therefore on defined structural changes in the sacroiliac joint as detected by conventional radiographs. However, x-rays are not able to detect early stages of the disease in which inflammation predominates and irreversible structural changes have not yet taken place. This probably contributes to a substantial time delay until a diagnosis is made. Magnetic resonance imaging (MRI) is able to visualize active and chronic changes in axial and peripheral spondyloarthritis (SpA) even before the occurrence of structural changes. The ability to demonstrate both active and, in a limited way, also structural changes makes MRI a diagnostic tool of increasing importance in the management of SpA. However, conventional radiographs are still the gold standard for the assessment of structural changes in SpA. A combination of both imaging techniques is recommended in clinical practice.
强直性脊柱炎(AS)的诊断基于改良的纽约标准,因此基于传统X线片检测到的骶髂关节明确的结构变化。然而,X线无法检测到疾病的早期阶段,此时炎症为主且尚未发生不可逆的结构变化。这可能导致诊断出现相当长的时间延迟。磁共振成像(MRI)甚至在结构变化出现之前就能显示轴性和外周脊柱关节炎(SpA)的活动期和慢性期变化。能够显示活动期变化以及在一定程度上显示结构变化,使得MRI成为SpA管理中越来越重要的诊断工具。然而,传统X线片仍是评估SpA结构变化的金标准。临床实践中建议将这两种成像技术结合使用。