Eur Radiol:儿童骶髂关节软骨下T2高信号是否能诊断为骶髂关节炎?

2021-03-07 shaosai MedSci原创

骶髂关节的磁共振成像(MRI)是诊断脊柱性关节炎(SpA)中骶髂关节炎的重要影像学检查,特别是在影像学改变明显之前,就能早期发现如骨髓水肿等早期炎性改变。

    骶髂关节的磁共振成像(MRI)是诊断脊柱性关节炎(SpA)中骶髂关节炎的重要影像学检查,特别是在影像学改变明显之前,就能早期发现如骨髓水肿(BME)等早期炎性改变。国际脊柱炎协会(ASAS)MRI评估标准定义,如果在软骨下区域的存在典型形态BME时,则认为是骶髂关节炎“阳性”,无论SIJ炎的其他MRI特征是否存在。然而,儿童在自然成长过程中会产生类似BME的水肿信号改变,这使得儿童骶髂关节炎的诊断十分困难。在骨化过程中,儿童的年龄、性别、位置和骶突闭合情况的不同,会在MRI T2序列上表现出不同的信号变化。


    近日,发表在European Radiology杂志的一项研究根据位置、年龄、性别和骶突闭合情况评价了儿童骶髂关节(SIJ) 软骨下T2信号变化模式的差异。

    在征得家长知情同意的情况下,对251名儿童(132名女童)共502例SIJ 进行了MRI检查,平均年龄12.4岁(范围6.1 ~ 18.0)。251名患者中有127名没有相应的关节症状,并出于非风湿病的原因进行了影像学检查;124名患者在最初的临床MRI检查中有下腰痛的症状,但没有骶髂关节炎的相应症状。校准后,三位专科放射科医师分别在4个位置的脂肪抑制液体敏感序列从0到3对软骨下信号变化进行评分,并对骶突的闭合程度进行分级。同时分析了患者年龄、性别、信号改变和骶突闭合之间的关系。

    边缘样或“开口样”软骨下T2高信号在SIJ骶骨缘较髂骨缘更常见(72% vs 16%, p < 0.001),且大于90%的儿童呈对称性改变。除1例患儿外,髂骨侧外扩评分均低于骶骨侧评分。信号改变随着骶突的闭合而减少,并且在骶突完全闭合的受试者中见到信号改变概率小于 20%。信号改变在男孩中发现率更高,其信号强度达峰值的年龄比女孩更晚(8-12岁vs. 7-10岁)。髂嵴软骨下信号在整个儿童时期都是高的,且与其他部位无关。

表 根据骶突闭合状态不同评估“开口”阳性的比例及两两比较的广义估计方程(GEE)模型。

    正常儿童骶髂关节MRI信号变化随年龄和性别的变化可表现为以下征象:T2序列上软骨下边缘信号增加是正常表现;正常的信号改变通常是对称的,主要发生在关节的骶侧。当T2信号不对称、髂侧更严重或在青少年闭合的骺端见到t2高信号时,常提示为病理性骨髓水肿。髂嵴软骨下信号在整个儿童时期都呈明显的t2高信号,不能作为诊断标准的参考。本研究为正确区分正常和病理的儿童骶髂关节软骨下信号改变提供了理论支持,避免了骶髂炎的误诊和漏诊。


原始出处:

Nele Herregods,Lennart B O Jans,Min Chen,et al. Normal subchondral high T2 signal on MRI mimicking sacroiliitis in children: frequency, age distribution, and relationship to skeletal maturity.DOI:10.1007/s00330-020-07328-0

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  2. [GetPortalCommentsPageByObjectIdResponse(id=1950823, encodeId=711419508239b, content=<a href='/topic/show?id=20101021e97e' target=_blank style='color:#2F92EE;'>#高信号#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=40, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=102179, encryptionId=20101021e97e, topicName=高信号)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=08e4137, createdName=meichuangyi, createdTime=Wed Nov 24 05:57:38 CST 2021, time=2021-11-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1735911, encodeId=66fe1e35911f8, content=<a href='/topic/show?id=2af23014609' target=_blank style='color:#2F92EE;'>#关节软骨#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=42, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=30146, encryptionId=2af23014609, topicName=关节软骨)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=165434038855, createdName=anan, createdTime=Sat Jul 24 02:57:38 CST 2021, time=2021-07-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=957116, encodeId=15a195e116ba, content=非常有价值,对于青少年骶髂关节病理性骨髓水肿有指导意义, beContent=null, objectType=article, channel=null, level=null, likeNumber=77, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c3c31528806, createdName=gqylhd, createdTime=Wed Apr 14 23:26:15 CST 2021, time=2021-04-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1266264, encodeId=c34512662640d, content=<a href='/topic/show?id=57a53011364' target=_blank style='color:#2F92EE;'>#关节炎#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=43, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=30113, encryptionId=57a53011364, topicName=关节炎)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=f90281, createdName=lmm397, createdTime=Tue Mar 09 03:57:38 CST 2021, time=2021-03-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1352622, encodeId=57cc1352622cf, content=<a href='/topic/show?id=4cf110204168' target=_blank style='color:#2F92EE;'>#骶髂关节炎#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=44, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=102041, encryptionId=4cf110204168, topicName=骶髂关节炎)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=395f25, createdName=爆笑小医, createdTime=Tue Mar 09 03:57:38 CST 2021, time=2021-03-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1618610, encodeId=7cf116186107c, content=<a href='/topic/show?id=a533102040f0' target=_blank style='color:#2F92EE;'>#骶髂关节#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=34, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=102040, encryptionId=a533102040f0, topicName=骶髂关节)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=ea8919912031, createdName=ms7405317358118777, createdTime=Tue Mar 09 03:57:38 CST 2021, time=2021-03-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=946192, encodeId=ba9c94619265, content=这样标准太宽松了, beContent=null, objectType=article, channel=null, level=null, likeNumber=90, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20200914/f1df8506d5cb4909bac2efc340b6c1fe/dcc6dd2dbec44613838b555fbe723804.jpg, createdBy=686b1371609, createdName=liyu7822, createdTime=Sun Mar 07 17:05:25 CST 2021, time=2021-03-07, status=1, ipAttribution=)]
    2021-07-24 anan
  3. [GetPortalCommentsPageByObjectIdResponse(id=1950823, encodeId=711419508239b, content=<a href='/topic/show?id=20101021e97e' target=_blank style='color:#2F92EE;'>#高信号#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=40, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=102179, encryptionId=20101021e97e, topicName=高信号)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=08e4137, createdName=meichuangyi, createdTime=Wed Nov 24 05:57:38 CST 2021, time=2021-11-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1735911, encodeId=66fe1e35911f8, content=<a href='/topic/show?id=2af23014609' target=_blank style='color:#2F92EE;'>#关节软骨#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=42, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=30146, encryptionId=2af23014609, topicName=关节软骨)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=165434038855, createdName=anan, createdTime=Sat Jul 24 02:57:38 CST 2021, time=2021-07-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=957116, encodeId=15a195e116ba, content=非常有价值,对于青少年骶髂关节病理性骨髓水肿有指导意义, beContent=null, objectType=article, channel=null, level=null, likeNumber=77, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c3c31528806, createdName=gqylhd, createdTime=Wed Apr 14 23:26:15 CST 2021, time=2021-04-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1266264, encodeId=c34512662640d, content=<a href='/topic/show?id=57a53011364' target=_blank style='color:#2F92EE;'>#关节炎#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=43, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=30113, encryptionId=57a53011364, topicName=关节炎)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=f90281, createdName=lmm397, createdTime=Tue Mar 09 03:57:38 CST 2021, time=2021-03-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1352622, encodeId=57cc1352622cf, content=<a href='/topic/show?id=4cf110204168' target=_blank style='color:#2F92EE;'>#骶髂关节炎#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=44, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=102041, encryptionId=4cf110204168, topicName=骶髂关节炎)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=395f25, createdName=爆笑小医, createdTime=Tue Mar 09 03:57:38 CST 2021, time=2021-03-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1618610, encodeId=7cf116186107c, content=<a href='/topic/show?id=a533102040f0' target=_blank style='color:#2F92EE;'>#骶髂关节#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=34, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=102040, encryptionId=a533102040f0, topicName=骶髂关节)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=ea8919912031, createdName=ms7405317358118777, createdTime=Tue Mar 09 03:57:38 CST 2021, time=2021-03-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=946192, encodeId=ba9c94619265, content=这样标准太宽松了, beContent=null, objectType=article, channel=null, level=null, likeNumber=90, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20200914/f1df8506d5cb4909bac2efc340b6c1fe/dcc6dd2dbec44613838b555fbe723804.jpg, createdBy=686b1371609, createdName=liyu7822, createdTime=Sun Mar 07 17:05:25 CST 2021, time=2021-03-07, status=1, ipAttribution=)]
    2021-04-14 gqylhd

    非常有价值,对于青少年骶髂关节病理性骨髓水肿有指导意义

    0

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    2021-03-09 lmm397
  5. [GetPortalCommentsPageByObjectIdResponse(id=1950823, encodeId=711419508239b, content=<a href='/topic/show?id=20101021e97e' target=_blank style='color:#2F92EE;'>#高信号#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=40, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=102179, encryptionId=20101021e97e, topicName=高信号)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=08e4137, createdName=meichuangyi, createdTime=Wed Nov 24 05:57:38 CST 2021, time=2021-11-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1735911, encodeId=66fe1e35911f8, content=<a href='/topic/show?id=2af23014609' target=_blank style='color:#2F92EE;'>#关节软骨#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=42, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=30146, encryptionId=2af23014609, topicName=关节软骨)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=165434038855, createdName=anan, createdTime=Sat Jul 24 02:57:38 CST 2021, time=2021-07-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=957116, encodeId=15a195e116ba, content=非常有价值,对于青少年骶髂关节病理性骨髓水肿有指导意义, beContent=null, objectType=article, channel=null, level=null, likeNumber=77, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c3c31528806, createdName=gqylhd, createdTime=Wed Apr 14 23:26:15 CST 2021, time=2021-04-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1266264, encodeId=c34512662640d, content=<a href='/topic/show?id=57a53011364' target=_blank style='color:#2F92EE;'>#关节炎#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=43, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=30113, encryptionId=57a53011364, topicName=关节炎)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=f90281, createdName=lmm397, createdTime=Tue Mar 09 03:57:38 CST 2021, time=2021-03-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1352622, encodeId=57cc1352622cf, content=<a href='/topic/show?id=4cf110204168' target=_blank style='color:#2F92EE;'>#骶髂关节炎#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=44, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=102041, encryptionId=4cf110204168, topicName=骶髂关节炎)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=395f25, createdName=爆笑小医, createdTime=Tue Mar 09 03:57:38 CST 2021, time=2021-03-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1618610, encodeId=7cf116186107c, content=<a href='/topic/show?id=a533102040f0' target=_blank style='color:#2F92EE;'>#骶髂关节#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=34, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=102040, encryptionId=a533102040f0, topicName=骶髂关节)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=ea8919912031, createdName=ms7405317358118777, createdTime=Tue Mar 09 03:57:38 CST 2021, time=2021-03-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=946192, encodeId=ba9c94619265, content=这样标准太宽松了, beContent=null, objectType=article, channel=null, level=null, likeNumber=90, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20200914/f1df8506d5cb4909bac2efc340b6c1fe/dcc6dd2dbec44613838b555fbe723804.jpg, createdBy=686b1371609, createdName=liyu7822, createdTime=Sun Mar 07 17:05:25 CST 2021, time=2021-03-07, status=1, ipAttribution=)]
  6. [GetPortalCommentsPageByObjectIdResponse(id=1950823, encodeId=711419508239b, content=<a href='/topic/show?id=20101021e97e' target=_blank style='color:#2F92EE;'>#高信号#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=40, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=102179, encryptionId=20101021e97e, topicName=高信号)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=08e4137, createdName=meichuangyi, createdTime=Wed Nov 24 05:57:38 CST 2021, time=2021-11-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1735911, encodeId=66fe1e35911f8, content=<a href='/topic/show?id=2af23014609' target=_blank style='color:#2F92EE;'>#关节软骨#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=42, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=30146, encryptionId=2af23014609, topicName=关节软骨)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=165434038855, createdName=anan, createdTime=Sat Jul 24 02:57:38 CST 2021, time=2021-07-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=957116, encodeId=15a195e116ba, content=非常有价值,对于青少年骶髂关节病理性骨髓水肿有指导意义, beContent=null, objectType=article, channel=null, level=null, likeNumber=77, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c3c31528806, createdName=gqylhd, createdTime=Wed Apr 14 23:26:15 CST 2021, time=2021-04-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1266264, encodeId=c34512662640d, content=<a href='/topic/show?id=57a53011364' target=_blank style='color:#2F92EE;'>#关节炎#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=43, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=30113, encryptionId=57a53011364, topicName=关节炎)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=f90281, createdName=lmm397, createdTime=Tue Mar 09 03:57:38 CST 2021, time=2021-03-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1352622, encodeId=57cc1352622cf, content=<a href='/topic/show?id=4cf110204168' target=_blank style='color:#2F92EE;'>#骶髂关节炎#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=44, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=102041, encryptionId=4cf110204168, topicName=骶髂关节炎)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=395f25, createdName=爆笑小医, createdTime=Tue Mar 09 03:57:38 CST 2021, time=2021-03-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1618610, encodeId=7cf116186107c, content=<a href='/topic/show?id=a533102040f0' target=_blank style='color:#2F92EE;'>#骶髂关节#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=34, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=102040, encryptionId=a533102040f0, topicName=骶髂关节)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=ea8919912031, createdName=ms7405317358118777, createdTime=Tue Mar 09 03:57:38 CST 2021, time=2021-03-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=946192, encodeId=ba9c94619265, content=这样标准太宽松了, beContent=null, objectType=article, channel=null, level=null, likeNumber=90, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20200914/f1df8506d5cb4909bac2efc340b6c1fe/dcc6dd2dbec44613838b555fbe723804.jpg, createdBy=686b1371609, createdName=liyu7822, createdTime=Sun Mar 07 17:05:25 CST 2021, time=2021-03-07, status=1, ipAttribution=)]
  7. [GetPortalCommentsPageByObjectIdResponse(id=1950823, encodeId=711419508239b, content=<a href='/topic/show?id=20101021e97e' target=_blank style='color:#2F92EE;'>#高信号#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=40, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=102179, encryptionId=20101021e97e, topicName=高信号)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=08e4137, createdName=meichuangyi, createdTime=Wed Nov 24 05:57:38 CST 2021, time=2021-11-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1735911, encodeId=66fe1e35911f8, content=<a href='/topic/show?id=2af23014609' target=_blank style='color:#2F92EE;'>#关节软骨#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=42, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=30146, encryptionId=2af23014609, topicName=关节软骨)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=165434038855, createdName=anan, createdTime=Sat Jul 24 02:57:38 CST 2021, time=2021-07-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=957116, encodeId=15a195e116ba, content=非常有价值,对于青少年骶髂关节病理性骨髓水肿有指导意义, beContent=null, objectType=article, channel=null, level=null, likeNumber=77, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c3c31528806, createdName=gqylhd, createdTime=Wed Apr 14 23:26:15 CST 2021, time=2021-04-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1266264, encodeId=c34512662640d, content=<a href='/topic/show?id=57a53011364' target=_blank style='color:#2F92EE;'>#关节炎#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=43, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=30113, encryptionId=57a53011364, topicName=关节炎)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=f90281, createdName=lmm397, createdTime=Tue Mar 09 03:57:38 CST 2021, time=2021-03-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1352622, encodeId=57cc1352622cf, content=<a href='/topic/show?id=4cf110204168' target=_blank style='color:#2F92EE;'>#骶髂关节炎#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=44, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=102041, encryptionId=4cf110204168, topicName=骶髂关节炎)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=395f25, createdName=爆笑小医, createdTime=Tue Mar 09 03:57:38 CST 2021, time=2021-03-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1618610, encodeId=7cf116186107c, content=<a href='/topic/show?id=a533102040f0' target=_blank style='color:#2F92EE;'>#骶髂关节#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=34, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=102040, encryptionId=a533102040f0, topicName=骶髂关节)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=ea8919912031, createdName=ms7405317358118777, createdTime=Tue Mar 09 03:57:38 CST 2021, time=2021-03-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=946192, encodeId=ba9c94619265, content=这样标准太宽松了, beContent=null, objectType=article, channel=null, level=null, likeNumber=90, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20200914/f1df8506d5cb4909bac2efc340b6c1fe/dcc6dd2dbec44613838b555fbe723804.jpg, createdBy=686b1371609, createdName=liyu7822, createdTime=Sun Mar 07 17:05:25 CST 2021, time=2021-03-07, status=1, ipAttribution=)]
    2021-03-07 liyu7822

    这样标准太宽松了

    0

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