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3D T1-VIBE序列用于评价强直性脊柱炎骶髂关节软骨的初步研究

作者:徐启兰1,2 洪国斌1 刘 强1 王一兵1 吴文浩1 阳莹丽1 李文娟1

所属单位:1.中山大学附属第五医院放射科(广东 珠海 519000) 2.安徽省六安市人民医院放射科(安徽 六安 237000)

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摘要

目的采用三维容积内插体部扫 描序列(3D T1-VIBE)对强直性脊柱炎(AS) 患者骶髂关节(SIJ)软骨进行扫描,分析 其MRI表现,探讨3D T1-VIBE序列显示SIJ 软骨的可行性。方法 利用3D T1-VIBE序 列对10名AS患者共20侧SIJ软骨进行MR扫 描,着重观察SIJ软骨。结果 10例中3例 髂侧关节软骨边缘模糊,部分层面可见 SIJ软骨二者间隙;7例显示关节面模糊, 不能区分出骶侧与髂侧关节软骨及其二者 间隙,关节软骨侵蚀破坏、连续性中断。 结论 3D T1-VIBE序列能较X线和CT更好显 示AS患者SIJ软骨的侵蚀破坏,髂侧关节 软骨的模糊、微侵蚀和关节软骨间隙消 失是诊断早期骶髂关节炎(SIS)的重要征象。

Objective The purpose of the study was to evaluate the feasibility and application value of MR 3D T1-Weighted Gradient-Echo Imaging with a volumetric interpolated breath-hold examination (3D T1WI-VIBE) in the evaluation of joint cartilage of SIJ in patients with ankylosing spondylitis. Methods A total of 10 AS patients were collected randomly and the 3D T1-VIBE were performed for sacroiliac joint. MR manifestation of sacroiliac articular cartilage of 10 cases of ankylosing spondylitis patients were observed. Results 3D T1-VIBE sequence were performed in 10 patients (20 SIJs) with ankylosing spondylitis, blur iliac side edge of articular cartilage were showed in 3 cases. The gap between cartilage in the sacral and iliac side become unclear and even disappear, seven of ten articular cartilage shown erosion damage, discontinuous change. Conclusions 3D T1-VIBE can show the destroy and break of the articular cartilage in patients of AS. 3D T1-VIBE is a valuable technique for examination of articular cartilage of SIJ, which provides more information for clinic than X-ray and CT.

【关键词】骶髂关节;关节软骨;磁共振成像

【中图分类号】R681;R445.2

【文献标识码】A

【DOI】10.3969/j.issn.1672-5131.2015.03.30

前言

骶髂关节(sacroiliac joint,SIJ)软骨异常及骨髓水肿被认为 是早期骶髂关节炎(sacroiliitis,SIS)的MRI改变之一[1,2],Docnerty 等认为骨髓水肿是软骨变性的继发改变[3]。骶髂关节(sacroiliac joint,SIJ)由骶骨与髂骨耳状面构成,其位置深在,关节面嵌合紧 密,走向扭曲,关节间隙窄,解剖结构复杂,个体差异较大[4]。MRI 是目前唯一能够直接显示SIJ软骨的影像学方法,常规MRI序列虽然可 以显示骶髂关节软骨,但仅能显示出SIJ间隙内的软骨信号[5-7],很难 清晰区分出骶侧软骨、髂侧软骨及两者之间的间隙。