Korb Cheri, Awisat Abid, Rimar Doron, Rosner Itzhak, Schpigelman Arsen, Militianu Daniela, Slobodin Gleb
Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel.
Rheumatology Unit, Bnai Zion Medical Center, Haifa, Israel.
Isr Med Assoc J. 2017 Nov;19(11):682-684.
Magnetic resonance imaging (MRI), which has recently become the leading imaging modality in the study of ankylosing spondylitis (AS), has not been evaluated in the assessment of disease-specific changes at the craniocervical junction (CCJ) in patients with AS.
To describe the spectrum of active inflammatory lesions at the CCJ using MRI in a cohort of patients with AS and neck pain.
The study included 18 patients with AS presenting with neck pain and a control group of 9 fibromyalgia patients matched for age and levels of neck pain. All patients underwent a focused rheumatologic examination, X-ray of the cervical spine, and a 3T MRI study, which included STIR, CUBE T2, FSE and FSE FAT SAT sequences before and after administration of gadolinium.
The median age of AS patients was 43 years with a median disease duration of 7 years. Fifteen of 18 patients were under biologic treatment. Seven of 18 AS patients had evidence of cervical syndesmophytes on X-ray films. Active inflammatory lesions of atlanto-occipital joints and apical and alar ligaments were detected in MRIs in 2 out of the 18 patients with AS and in none of the patients with fibromyalgia. Both AS patients with active inflammation of CCJ detected on MRI received treatment with biological agents prior to and during the study.
Active inflammation of both entheses and joints of the CCJ can be demonstrated by MRI in patients with AS.
磁共振成像（MRI）最近已成为强直性脊柱炎（AS）研究中的主要成像方式，但尚未用于评估AS患者颅颈交界区（CCJ）的疾病特异性变化。
利用MRI描述一组有颈部疼痛的AS患者CCJ处的活动性炎性病变谱。
该研究纳入了18例有颈部疼痛的AS患者以及一个由9例年龄和颈部疼痛程度相匹配的纤维肌痛患者组成的对照组。所有患者均接受了针对性的风湿病学检查、颈椎X线检查以及一项3T MRI研究，该研究在注射钆对比剂前后包括短反转恢复序列（STIR）、容积式各向同性体部表面线圈T2加权成像（CUBE T2）、快速自旋回波序列（FSE）和脂肪抑制快速自旋回波序列（FSE FAT SAT）。
AS患者的中位年龄为43岁，中位病程为7年。18例患者中有15例正在接受生物治疗。18例AS患者中有7例在X线片上有颈椎骨桥的证据。18例AS患者中有2例在MRI上检测到寰枕关节以及齿突尖韧带和翼状韧带的活动性炎性病变，而纤维肌痛患者中无一例检测到。在MRI上检测到CCJ有活动性炎症的2例AS患者在研究之前和研究期间均接受了生物制剂治疗。
MRI可显示AS患者CCJ的起止点和关节的活动性炎症。
