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[轴向型脊柱关节炎的磁共振成像(MRI)诊断]

[Magnetic resonance imaging (MRI) diagnostics in axial spondyloarthritis].

作者信息

Witte T, Baraliakos X

机构信息

Klinik für Immunologie und Rheumatologie, Medizinische Hochschule Hannover, Carl-Neuberg-Str. 1, 30625, Hannover, Deutschland.

Rheumazentrum Ruhrgebiet Herne, Ruhr-Universität Bochum, Bochum, Deutschland.

出版信息

Z Rheumatol. 2017 Sep;76(7):574-579. doi: 10.1007/s00393-017-0361-x.

Abstract

BACKGROUND

Axial spondyloarthritis (axSpA) is a frequent disorder, which is difficult to diagnose in the early phase. Currently, magnetic resonance imaging (MRI) of the sacroiliac joints and the spine is frequently applied in this phase, when conventional X rays still provide inconclusive results.

OBJECTIVE

To explain the typical pathological results and the role of MRI in diagnosing axSpA.

RESULTS

The use of MRI of the sacroiliac joints plays a central role in the assessment of the Spondyloarthritis International Association Society (ASAS) classification criteria of axSpA. Bone marrow edema is central to the definition of a positive MRI of the sacroiliac joints. In addition, chronic changes in the sacroiliac joints, such as fat depositions and erosion are taken into account in making the diagnosis of axSpA. When the results are not clear, an additional MRI of the area of the spine in which the patient reports the most pronounced complaints can be performed. A bone marrow edema in at least three vertebral edges can be associated with axSpA.

CONCLUSION

The MRI investigation of the sacroiliac joints has evolved into one of the most important methods in diagnosing axSpA.

摘要

背景

轴性脊柱关节炎(axSpA)是一种常见疾病,早期难以诊断。目前,当传统X线检查结果仍不明确时,骶髂关节和脊柱的磁共振成像(MRI)在这一阶段经常被应用。

目的

解释axSpA典型的病理结果及MRI在其诊断中的作用。

结果

骶髂关节MRI的应用在axSpA的国际脊柱关节炎协会(ASAS)分类标准评估中起着核心作用。骨髓水肿是骶髂关节MRI阳性定义的关键。此外,骶髂关节的慢性改变,如脂肪沉积和侵蚀,在axSpA的诊断中也会被考虑。当结果不明确时,可以对患者主诉最明显的脊柱区域进行额外的MRI检查。至少三个椎体边缘的骨髓水肿可能与axSpA有关。

结论

骶髂关节的MRI检查已发展成为诊断axSpA最重要的方法之一。

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