目 的 探讨强直性脊柱炎 (ankylosing spondylitis，AS)伴发 Andersson损害(Andersson lesion，AL) 的影像表现特征。方法 回顾分析中山市 中医院2012年1月至2017年6月收治的AS 伴发AL患者的影像及临床资料。共10个 患者11个病灶，其中男9例，女2例；年 龄36-79岁，中位年龄52岁。11例均行 X光检查；行CT检查8例；MRI检查6例， 其中3例行MRI增强扫描； 3例同时行CT 及MRI检查。结果 11例病变位于T10-S1 间，累及椎体1例，椎间盘10例。5例为 分离型AL，4例为炎症型AL，2例为混合 型。X线诊断8例，漏诊3例，其中分离型 2例，炎症型1例。8例行CT检查的AL患者 中，3例为分离型，2例为炎症型，2例为 混合型，其中CT漏诊1例早期炎症型AL； 4例椎间盘见真空征；1例见死骨。6例行 MRI检查的AL患者，2例为分离型AL，4例 为炎症型AL；2例病灶周围表现轻度水 肿，3例重度水肿；1例椎旁见软组织肿 块；3例行MRI增强扫描炎症型AL均呈环 形强化。结论 强直性脊柱炎中AL多累及 椎间盘，真空征有助于分离型AL诊断， 炎症型AL少或无死骨及软组织肿块形 成。X线对于早期分离型及炎症型AL均容 易漏诊，CT对于分离型AL具有较好诊断 效果，MRI则对AL具有更高诊断准确性。

Objective To explore the imaging findings characteristics of ankylosing spondylitis (AS) combined Andersson lesions (AL). Methods The clinical and imaging data of patients who diagnosed as AS combined AL at zhongshan hospital of Traditional Chinese Medicine between January 2012 and June 2017 were reviewed retrospectively. A total of 10 patients were with 11 lesions, including 9 cases of male and 2 cases of female. Age was from 36 to 79, the median age was 52. All the cases underwent X-ray examination, 8 cases underwent CT scan,6 cases underwent MRI plain scan and 3 cases underwent MRI enhanced scan, of which 3 cases underwent CT and MRI scan. Results 11 cases of lesions located in between T10 - S1, 1 case involved vertebral body, 10 cases involved intervertebral disc. 5 cases were separation AL, 4 cases were inflammatory AL, 2 cases were combined AL. X-ray diagnosis of 8 cases, 3 cases were misdiagnosed, including 2 of separation AL and 1 of inflammation AL. 8 case underwent CT scan, including 3 cases of separation AL, 2 cases of inflammatory AL and 1 case of combined AL. 4 cases of intervertebral disc showed vacuum sign; 1 case seed necrotic bone.6 cases underwent MRI, including 1 cases of separation AL and 5 cases of inflammatory AL, 2 cases of lesions showed mild edema around, 3 cases showed severe edema. 1 cases of vertebral side showed mass lesion. 3 cases showed ring enhancement which underwent MRI enhanced scan. Conclusion Ankylosing spondylitis more involve the intervertebral disc, vacuum sign help diagnosis of separation AL, inflammatory AL have little or no necrotic bone and soft tissue mass formation. X-ray for early AL are easily missed diagnosis, CT has good diagnosis effect for separation type AL, MRI has higher diagnosis accuracy for AL. [Key words] Ankylosing Spondylitis; Andersson Lesion; Spine; Tomography, X-ray Computed; Magnetic Resonance Imaging