MacKay K, Mack C, Brophy S, Calin A
Royal National Hospital for Rheumatic Diseases, Bath, UK.
Arthritis Rheum. 1998 Dec;41(12):2263-70. doi: 10.1002/1529-0131(199812)41:12<2263::AID-ART23>3.0.CO;2-I.
To develop a reproducible and simple radiologic scoring system for the spine in patients with ankylosing spondylitis (AS): the Bath Ankylosing Spondylitis Radiology Index for the spine (BASRI-s).
Radiographs of 470 patients with AS were scored using the New York criteria for the sacroiliac joints and, similarly, grading the lumbar and cervical spine on a scale of 0-4 (for normal, suspicious, mild, moderate, and severe). These 3 scores were added together to produce the BASRI-s score (scored 2-12). Radiographs of 188 patients were used to test reproducibility. Blinded radiographs of 89 non-AS patients were included, randomly, to assess disease specificity. Sensitivity to change was assessed using 177 radiographs from 58 AS patients.
Intra- and interobserver variation showed 75-86% and 73-79% complete agreement at all sites, respectively. Specificities of 0.83-0.89 suggested that the lumbar and cervical spine BASRI scores were disease specific. Sensitivity to change became apparent at 2 years (P < 0.001). Using a lateral view and an anteroposterior view of the lumbar spine was more sensitive than using a lateral view alone. Grading a set of radiographs (sacroiliac joints, lumbar spine, and cervical spine) took 30 seconds.
BASRI is a reliable method for grading radiographic changes in patients with AS. It is disease specific, sensitive to change, valid, simple, and rapid to perform.
为强直性脊柱炎（AS）患者开发一种可重复且简单的脊柱放射学评分系统：脊柱的巴斯强直性脊柱炎放射学指数（BASRI-s）。
使用骶髂关节的纽约标准对470例AS患者的X线片进行评分，同样，对腰椎和颈椎按0 - 4级进行分级（分别对应正常、可疑、轻度、中度和重度）。将这3个评分相加得出BASRI-s评分（评分范围为2 - 12分）。使用188例患者的X线片测试可重复性。随机纳入89例非AS患者的盲法X线片以评估疾病特异性。使用58例AS患者的177张X线片评估对变化的敏感性。
观察者内和观察者间的变异显示，在所有部位的完全一致性分别为75 - 86%和73 - 79%。0.83 - 0.89的特异性表明腰椎和颈椎的BASRI评分具有疾病特异性。对变化的敏感性在2年时变得明显（P < 0.001）。使用腰椎的侧位片和前后位片比仅使用侧位片更敏感。对一组X线片（骶髂关节、腰椎和颈椎）进行分级需要30秒。
BASRI是评估AS患者放射学改变的可靠方法。它具有疾病特异性，对变化敏感，有效、简单且执行迅速。
