강직성척추염에서 천골장골관절염에 대한 다중 검출기 CT와 단순촬영의 비교 = Sacroiliitis in Ankylosing Spondylitis: Comparison with Multidetector Row CT and Plain Radiography

다국어 초록 (Multilingual Abstract)

Purpose: The objective of our study was to compare multidetector row CT and the plain radiographs for making the diagnosis and grading the sacroiliitis that accompanies ankylosing spondylitis. We wanted to determine the role of multidetector row CT for the evaluation of the sacroilitis in patients with ankylosing spondylitis.
Materials and Methods: One hundred ninety two patients with clinically suspected ankylosing spondylitis were evaluated by conventional radiography and multidetector row CT. Two musculoskeletal radiologists retrospectively analyzed the images, and they graded the sacroiliitis using the modified New York Criteria.
Results: Multidetector row CT demonstrated a significantly higher sensitivity (74.5%, 83.3%) than did plain radiography (59.9%, 66.7%) for detecting early sacroiliitis (p<0.05). Multidetector row CT showed a higher grade of sacroiliitis in 114 and 127 of 384 sacroiliac joints.
Conclusion: Performing multidetector row CT rather than plain radiography for making the diagnoses of accompanying ankylosing spondylitis allows an early start of treatment with a subsequently improved prognosis.

국문 초록 (Abstract)

목적: 본 연구의 목적은 강직성척추염이 의심되는 환자를 대상으로 천골장골관절염의 진단에 있어 다중 검출기 CT의 유용성에 대해 단순촬영과 비교 분석하는데 있다.
대상과 방법: 임상적으로 강직성척추염이 의심되는 192명의 환자를 대상으로 천골장골관절염의 진단을 위하여 단순촬영과 다중 검출기 CT를 함께 시행하였다. 이 검사들은 두 명의 근골격계 영상의학과 의사에 의해 Modified New York Criteria에 준하여 후향적으로 분석하였다.
결과: 단순촬영과 다중 검출기 CT에서 천골장골관절염 진단에 대한 민감도는 각각 59.9%, 66.7%, 83.3%, 74.5%였고, 다중 검출기 CT를 이용하여 천골장골관절염으로 진단된 환자의 수가 단순촬영을 이용했을 때보다 통계적으로 유의하게 증가함이 관찰되었다( p < 0.05). 등급별 분류에 따른 분석에서는 384개의 천골장골관절 중 114개, 127개(29.7%, 33.1%)의 천골장골관절이 다중 검출기 CT에서 단순촬영보다 높은 등급으로 평가되었다.
결론: 강직성척추염과 동반된 천골장골관절염 평가에 있어 다중 검출기 CT는 단순촬영만으로는 진단이 어려운 조기 천골장골관절염의 진단을 가능하게 하여 치료 방법 결정 및 예후에 도움을 줄 수 유용한 방법이라 하겠다.

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