Ann Rheum Dis:与常规影像比较,低剂量CT可以检测强直性脊柱炎更多骨形成进展

2017-11-12 xiangting MedSci原创

与CR相比,ldCT覆盖AS患者的整个脊柱,并可以发现更多的新生和进展韧带骨赘形成。

这项研究旨在比较强直性脊柱炎(AS)患者的低剂量CT(ldCT)韧带骨赘评分(CTSS)与常规X线片(CR)改良斯托克强直性脊柱炎脊柱评分(mSASSS)。

强直性脊柱炎敏感影像学队列中的AS患者在基线和2年时进行侧颈椎和腰椎CR检查和全脊椎ldCT检查。CR和ldCT影像由两位阅片者进行评分,根据患者配对,遮挡时间顺序,按照每个成像模式进行。对于总分分析,使用阅片者ldCT上的1/4象限或CR每个角的平均分。对于韧带骨赘分析,关于同一个角/象限新的或进展的韧带骨赘使用单个阅片者和共识分数。

共有50例患者被纳入韧带骨赘分析,37例进行总分分析。基线mSASSS(范围0-72)和CTSS(范围0-552)的平均(SD)评分分别为17.9(13.8)和161.6(126.6),平均进展为2.4(3.8)和17.9(22.1)。对于单个阅片者,与CR上≥3个角比较,3倍的患者ldCT上≥3象限出现新的或进展韧带赘生物。达成共识后这增加到了5倍。50例患者中,CR上见到36个新的或进展的韧带骨赘,而ldCT上有151个,并且大多数在胸椎中发现。

与CR相比,ldCT覆盖AS患者的整个脊柱,并可以发现更多的新生和进展韧带骨赘形成,而CR仅限于颈椎和腰椎。大多数进展发生在胸椎。

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