骶髂关节正位放射学分型及其临床意义
The types of the sacroiliac joint on the pelvic anteroposterior radiography and its clinical implications
目的 探讨骨盆正位X线片上骶髂关节的放射学分型,以指导临床对骶髂关节的认知。 方法 对950例(男475,女475)正常骶髂关节的骨盆正位X线片进行观测。根据骶髂关节间隙的数量及间隙的走行特点,对骶髂关节进行放射学分型。 结果 正常骶髂关节的放射学分型大致可分为3种类型:① I型为双侧单间隙型,男女分别为8.8%(42例)和25.7%(122例);②Ⅱ型为双侧双间隙型,男女分别为79.2%(376例)和46.7%(222例);③Ⅲ型为一侧单间隙,一侧双间隙型,男女分别为12%(57例)和27.6%(131例)。II型又分为四个亚型:①“2”型双间隙,男女分别为0.8%(3例)和6.6%(15例);②“12”型双间隙,男女分别为56.4%(212例)和69.8%(155例);③“21”型双间隙,男女分别为2.1%(8例)和1.8%(4例);④“121”型双间隙,男女分别为41.8%(157例)和19.8%(44例);III型也分为两个亚型:①左侧单间隙,右侧双间隙型的男女分别为26.3%(15例)和49.6% (65例);②左侧双间隙,右侧单间隙型的男女分别为73.7% (42例)和50.4% (66例)。 结论 正常人骶髂关节的放射学分型以双侧双间隙型最常见,其中又以“12”型双间隙所占构成比最大,但各型构成上有性别差异。
Objective To explore the radiological types of the sacroiliac joint on the anteroposterior radiography of the pelvis, providing guidance for the clinicians to know more about the sacroiliac joint.Methods 950 cases (male and female account for half respectively) of normal sacroiliac joints were observed on the anteroposterior radiography of the pelvisand then the radiological types of the sacroiliac joint were classified according to the number of the sacroiliac spaces and the characteristics of their shape. Result (1) The normal sacroiliac joints on the anteroposterior radiography of the pelvis can be classified to three types: ①8.8% of males (42 cases) and 25.7% of females (122 cases) were classified as type I, which was called single gap on both sides type;②79.2% of males(376 cases) and 46.7% of females(222 cases) were classified as type II, which was called double gaps on both sides type;③12% of males(57 cases) and 27.6% of females(131 cases) were classified as type III, which was called one side single gap and the other side double gaps type;(2) Double gaps on both sides type can be particularly classified to four subtypes:①0.8% of males(3 cases) and 6.6% of females(15 cases) were classified as 2 double gaps type;②56.4% of males(212 cases) and 69.8% of females(155 cases) were classified as 12 double gaps type;③2.1% of males(8 cases) and 1.8% of females(4 cases) were classified as 21 double gaps type;④41.8% of males(157 cases) and 19.8% of females(44 cases) were classified as 121 double gaps type;(3) One side single gap and the other side double gaps type can also be classified to two subtypes:①26.3% of males(15 cases) and 49.6% of females(65 cases) were classified as Single gap on left and double gaps on right type;②73.7% of males(42 cases) and 50.4% of females(66 cases) were classified as double gaps on left and single gap on right type. Conclusions (1) The most common type of the normal sacroiliac joints on the anteroposterior radiography of the pelvis is the double gaps on both sides type, in which the largest proportion of all four subtypes is the “12” double gaps type, but the constituent ratio of each type on gender has a significant variation.
Sacroiliac joint / Anteroposterior radiography of the pelvis / Radiology's types / Clinical significance
[1] 王红,冯成堂. 骶髂关节平片检查位置的正常X线解剖研究[J]. 新疆医科大学学报,2004,27(5):541-546.
[2] 李义凯. 软组织痛的基础和临床[M]. 香港:世界医药出版社,2011:464-470.
[3] 吴世行,粟永明,罗国英. CT诊断强直性脊柱炎的价值[J].右江医学,2006,34(1):40-42.
[4] 颜小琼,张家雄,黄饪坚,朱通伯. 拟定I期AS的影像学诊断[J]. 放射学实践,2004, 19(1):3-5.
[5] 周以钦,陈玉珍. 强直性脊柱炎早期X线诊断[J]. 放射学实践,2000,15(3):206.
[6] Gotz W, Funke M, Fischer, et al. Epiphysial ossification centres in iliosacral joints:Anatomy and computed tomograhy. Surg Radio Anatomy, 1993,15:131.
[7] 邹宇聪,李义凯,杨先文,陈润琪,于成福. 骶髂关节未经影像学引导下穿刺的解剖学基础[J].中国临床解剖学杂志,2012,30(3):275-278.
[8] 陈亮,唐天驷. 强直性脊柱炎早期诊断和系统治疗[J]. 临床骨科杂志,2002,5(1):27-29.
[9] 陈伟,胡春平.强直性脊柱炎诊治体会[J]. 中医药学刊,2005,23(9):1667-1670.
[10] 金朝晖. 强直性脊柱炎的早期诊断[J]. 北京医学,2005,27(11):688-689.
[11] Law son TL, Valkenburg HA, Cat SA, et al. The sacroiliac join: anatomic plain roentgenographic and computed tomographicanalysis[J]. Comput Assist Tomogr, 1982,6:307-314.
[12] Fam AG. Computed tomography in the diagnosis of early ankylosing spondylitis[J]. Arthr and Rheum.1985,28:930.
[13] 管玥,王滨,张仕状. 强直性脊柱炎的影像学诊断研究进展[J].潍坊医学院学报,2004,26(2):138-141.
[14] 曹铁梅,姬艳波,等. 骶髂关节放射学检查在强直性脊柱炎诊断中的评价[J].中华风湿病学杂志,2002,6(3):207-209.
[15] 曾庆馀. 强直性脊柱炎的放射学诊断[J]. 山西医药杂志,1999,28(5):357-359.
[16] 钱齐荣,贾连顺. 骶髂关节的X线检查方法及其临床意义研究[J]. 骨与关节损伤杂志,2000,15(2):97-100.
[17] 陈正标,陈卫国. 强直性脊柱炎的X线平片和CT诊断[J]. 现代医用影像学,2006,15(2):88-90.
[18] 李兴福,宋立军,韩波. 对强直性脊柱炎早期诊断的思考[J]. 诊断学理论与实践,2004,3(4):237-239.
[19] 周实,周修国.强直性脊柱炎影像学检查与诊断现状[J]. 汕头大学医学院学报,1997,10(4):94-96.
[20] 张英琦,刘伟,付小勇,李义凯. 骶髂关节的放射解剖学观测[J]. 中国临床解剖学杂志,2009,27(1):73-75.
[21] 曾庆馀. 着力强直性脊柱炎早期诊断的研究[J]. 中华风湿病学杂志,2000,4(6):335-336.
[22] Brunner C, Kissling R, Jacob HAC. The effects of morphology and histopathologic finding on mobility of the sacroiliac joint [J]. Spine, 1991,16(9):111.
[23] Salsabili N. Variations in thickness of articular cartilage in the human sacroiliac joint[J]. Clin Anat,1995,8(6):388-390.
[24] 黄永火,孙向前. 骶髂关节解剖特点与X线表现的分析[J]. 中国医学影像技术,2001,17(4):372-374.
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