Mehmet Fatih İNCİ, Rahime İNCİ

Psöriazisli hastalarda sakroileitin manyetik rezonans görüntüleme bulguları

Amaç: Bu çalışmanın amacı, psöriazisli hastalardaki sakroileit sıklığını ve sakroileite ait karakteristik manyetikrezonans (MR) görüntüleme bulgularını belirlemektir.Yöntemler: Çalışmamıza hastanemiz Dermatoloji polikliniğinde, Şubat 2012-Şubat 2013 tarihleri arasında klinik ve histopatolojik olarak psöriazis tanısı konulan toplam 68 hasta dâhil edildi. Tüm hastalara bilateral sakroiliak MR inceleme yapıldı. MR görüntüleme, 1,5 T sistemde, koronal planda T1-ağırlıklı turbo spin-echo, T2-ağırlıklı ve yağ-baskılı short tau inversion recovery (STIR) sekansları ile uygulandı. Subkondral kemikteki değişiklikler MR sinyal özelliklerine göre sınıflandırıldı. Bulgular: Çalışmaya dâhil edilen hastaların 37’si (%54,4) erkek, 31’i (% 45,6) kadın idi. Yaşları 16-60 yıl arasında değişen hastaların yaş ortalaması 32,3±7,8 yıl olarak bulundu. Hastaların ortalama hastalık süresi 12,4±8,6 yıl (dağılım 2-24 yıl) idi. Toplam 68 psöriazis hastasının 52’sinde (%76,5) sakroileit lehine herhangi bir bulgu saptanmazken, 16 hastada (%23,5) sakroileit ile uyumlu sinyal değişiklikleri izlendi. Sakroileit saptanan 16 hastaya ait toplam 22 sakroiliak eklemde bir ya da birden çok radyolojik lezyonu saptadık. Manyetik rezonans incelemedeki patolojik bulgulara göre sınıflandırıldığında 6 (%27,3) eklemde Tip-1, 8 (%36,4) eklemde Tip-2, 10 (%45,5) eklemde Tip-3 değişiklik bulguları, 9 (%40,9) eklemde erezyon, 6 (%27,3) eklemde eklem mesafesinde daralma ve 5 (%22,7) eklemde ankiloz bulguları izlendi. Sonuç: Psöriazisli hastalarda sakroileit önemli bir problem teşkil etmektedir. MR görüntüleme psöriazisli hastalardaki sakroileit tanısında, sakroiliak eklem anatomisini ve sakroileit lezyonlarını ayrıntılı olarak gösterebilen veradyasyon maruziyeti olmayan non-invaziv yararlı bir görüntüleme yöntemidir.

Magnetic resonance imaging findings of sacroiliitis in patients with psoriasis

Objective: The aim of this study was to determine the frequency and characteristic magnetic resonance (MR) imaging features of sacroiliitis in patients with psoriasis disease. Methods: A total of 68 patients who diagnosed with psoriasis in Dermatology department of our hospital between February-2012 and February-2013 were included to our study. All patients were underwent bilateral sacroiliac MR. MR study were performed with the sequences of the coronal T1 weighted turbo spin-echo, T2 weighted and STIR images using a 1,5-T MR device for all patients. Changes in the subchondral bone were classified according to MR signal features. Results: Of these patients, 37 (54.4 %) were male and 31 (45.6 %) were female. The mean age was 32.3±7.8 years, ranging from 16 to 60 years. Mean disease duration was 12.4±8.6 years (2-24 years). While MR imaging findings were normal in 52 (76,5%) patients, signal changes consisted with sacroiliitis were observed in 16 (23.5%) patients. One or more MR lesion consisted with sacroiliitis were observed in a total of 22 sacroiliac joint of 16 patients. The signal abnormalities detected by MR imaging were as follows, Type-1 changes in 6 (27.3%) joints, Type-2 changes in 8 (36.4%) joints, Type-3 changes in 10 (45.5%) joints, erosions in 9 (40.9%) joints, narrowing the joints space in 6 (27.3%) joints and ankylosis in 5 (22.7%) joints. Conclusion: Sacroiliitis in psoriatic patients is an important clinical problem. MR imaging is a useful diagnostic modality in the diagnosis of psoriatic sacroiliitis which can demonstrate detailed anatomy of the sacroiliac joint and the changes of sacroiliitis without radiation exposure.

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