颈部钝伤齿突侧块间隙不对称CT扫描的价值  

Value of CT scanning in trauma patients with lateral atlanto-dental space asymmetry

作　　者：王志业[1] 陈新娟[1] 徐爱德[2] 

机构地区：[1]天津医科大学附属第一中心医院,天津300192 [2]青岛大学医学院附属医院放射科,山东266003

出　　处：《放射学实践》2004年第11期806-808,共3页Radiologic Practice

摘　　要：目的 :研究颈部钝伤齿突侧块间隙 (LADS)不对称患者功能位CT扫描时寰枢椎旋转角度 ,为临床有关疾病的诊断治疗提供帮助。方法 :3 0例正常人和 2 5例患者行中立位CT扫描 ,然后行左、右旋转 2 5°～ 45°功能位扫描 ,测量功能位寰枢椎相对旋转角度。结果 :3 0例正常人寰椎相对于枢椎的旋转角度大于 8°。 2 5例受伤者中 19例寰椎相对于枢椎的旋转角度大于 8° ,其余 1周后CT复查均大于 8° ,枢椎的运动弧度正常时应小于寰椎的 5 0 %。结论 :张口位平片显示LADS间隙不对称而临床无其他症状者无需进一步检查或治疗。而临床伴有旋转固定症状者 ,需用功能位CT扫描。Objective:To investigate the change of the relative rotation angle of C 1 on C 2 in the functional position CT scanning in trauma patients with lateral atlanto-dental space asymmetry.The purpose of the study is to help the diagnosis and treatment of the atlantoaxial rotatory fixation (AARF).Methods:30 healthy volunteers and 25 cases of trauma patients were scanned in neutral position first,then with the head rotating 25° to 45° to right and left respectively.Results:30 cases healthy volunteers had relative range of motion of C1 on C2 greater than 8°,19 of 25 patients had relative range of motion of C1 on C2 greater than 8° (average,16.5°),the others had a followup CT scan one week after initial presentation which demonstrated relative motion of C1 on C2 greater than 8°.The normal arc of motion of C2 should be less than 50% of the C1.Conclusion:Patients presenting with the finding of odontoid lateral mass asymmetry on open-mouth odontoid X-rays in the presence of an otherwise normal cervical spine series without fixed clinical deformity do not require further evaluation or treatment.Patients presenting with synptoms of atlanto-axial rotatory fixation should be evaluated by functional position CT scanning.

关 键 词：寰枢关节 旋转 体层摄影术 X线计算机 测量 创伤 颈 

分 类 号：R816.8[医药卫生—放射医学]