| 摘要: |
| 摘 要 目的 利用超声与CT融合成像对强直性脊柱炎（AS）骶髂关节区探及异常低阻血流信号的位置进行判断，从而辨别其组织来源。为证实多普勒低阻血流信号是评价AS的可靠指标提供有效依据。 方法 根据前期方法学研究，对84例AS患者实施经骶髂关节三对骶骨后孔层面（level）的超声与CT图像融合并对成功实施者进行多普勒超声检查。对两具骨盆标本实施骶髂关节系统解剖及断层解剖。根据其解剖学特点，对三个level处探及低阻血流信号的位置进行分类，以此判断其组织来源。结果 成功实施图像融合的AS患者中，3个level探及低阻血流信号数分别为128例，105例和61例。其组织学定位按照前期研究中关节内及周围分类法分布，各level间的差异有统计学意义（χ2= 9.101, P=0.011）。结合融合图像及解剖学研究结果，level 1及level 2处低阻血流信号几乎均位于关节韧带部；而level 3层面多数血流信号被定为于滑膜部；仅少数位于level 2及level 3层面处于滑膜部及韧带部交界处的血流信号在融合图像下无法精确定位。此分类方法各level间的差异有统计学意义（χ2=174.607, P<0.01）。结论 绝大多数骶髂关节后部超声测得的异常血流信号可通过超声与CT融合成像准确地定位于关节韧带部或滑膜部，以提示为不同的炎症类型。因此，课题组初步认为超声发现的关节后部低阻血流信号可作为评价AS的可靠指标之一，在早期诊断中可能更具优势，但需进一步超声与MRI图像融合研究来证实可靠性。 |
| 关键词: 强直性脊柱炎 骶髂关节 多普勒 CT 图像融合 |
| DOI： |
| 投稿时间：2019-11-05修订日期：2020-01-01 |
| 基金项目:国家自然科学基金面上项目(81571684) |
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| The value of US and CT fusion imaging in locating inflammatory blood flow signals detected by CDUS in sacroiliac joint of ankylosing spondylitis patients |
| hu zhen long,zhu jia an |
| () |
| Abstract: |
| ABSTRACT Objective To evaluate the effect of US-CT image fusion of the sacroiliac joints (SIJ) of ankylosing spondylitis(AS) patients to locate the active inflammatory activity as visualized by CDUS in these patients to confirm the sources of abnormal vascularization. The aim of this study is to provide an effective basis for confirming that Doppler abnormal blood flow signal is a reliable index to evaluate AS. Methods Based on preliminary methodology study, after successful US-CT image fusion of 84 patients at levels of 3 posterior sacral foramens, CDUS was performed to detect abnormal blood flow signals and to estimate their positions according to our studies of gross and sectional anatomy. The located abnormal signals were grouped into 3 regions according to the 3 levels. Results Among the successfully fused US-CT images of the SIJs in the patients group, CDUS revealed abnormal blood flow signals in 128 SIJs at level 1, 105 at level 2, and 61 at level 3. The interior of the SIJ and the area surrounding the SIJ were used to describe the location of these signals. The differences in abnormal blood flow signals among the 3 levels were significant (χ2 = 9.101, P = 0.011). Combined the fused US-CT images with anatomical study of SIJ, the locations of abnormal blood flow signals are initially confirmed: Almost all the cases at level 1 and level 2 were located at ligament part. However, the majority of signals at level 3 were located at synovial part. Only a few signals from level 2 and level were uncertain. The differences among the 3 levels were significant (χ2=174.607, P < 0.01). Conclusion This study demonstrated that US-CT fusion imaging can be used to locate abnormal blood flow signals in the SIJs visualized by CDUS. The signals at different levels indicate the occurrence of inflammation in different tissues of the posterior SIJ. US-CT imaging provides an effective basis for confirming that abnormal Doppler signal is a reliable index to evaluate AS and may be helpful in the diagnosis of AS patients at the early stage. However, several limitations still need to be resolved by fusion of US-MRI in the further studies. |
| Key words: Ankylosing spondylitis,Sacroiliac joint Doppler,CT, Fusion imaging |
