多层螺旋CT对齿状突骨折的诊断价值  

Applied Value of Multi-slice Spiral CT in Diagnosis of Odontoid Process Fracture

作　　者：龚瑞[1] 尹姬[1] 陈兵[1] 郭玉林[1] 金国宏[1] 刘娜佳[1] 

机构地区：[1]宁夏医学院附属医院放射科,宁夏银川750004

出　　处：《实用放射学杂志》2008年第4期452-455,共4页Journal of Practical Radiology

基　　金：宁夏回族自治区科技攻关计划项目(编号:宁科计字[2006]123号)

摘　　要：目的探讨多层螺旋CT(MSCT)对齿状突骨折的诊断价值。方法回顾性分析24例齿状突骨折的CT轴位薄层图像表现,对在工作站获取的薄层图像分别进行多平面重建(MPR),容积再现(VR),CT仿真内窥镜(CTVE)及四维透明显示(4D-Ray-sum)4种方法重建。有5例行颈前路加压螺丝内固定治疗的病例进行术前齿状突解剖数据的测量,并对16例复查病例的CT图像进行治疗前后对比分析。结果24例齿状突骨折根据Anderson及D’Alonzo分型,Ⅰ型1例,Ⅱ型15例(其中2例合并寰椎骨折),Ⅲ型8例。24例中行Halo氏外固定架治疗16例,行颈前路加压螺丝内固定治疗5例,行颈后路椎弓根螺钉内固定治疗3例。16例治疗后复查病例中,有9例行Halo氏外固定治疗,显示齿状突骨折复位满意,骨折愈合良好;有7例行内固定治疗,显示齿状突骨折复位满意,内固定物的位置良好。结论MSCT可作为齿状突骨折诊断及治疗评价的首选检查方法。Objective To study the applied value of multi - slice spiral CT（MSCT） in the diagnosis of odontoid process fractures, Methods CT axial view findings of odontoid process fracture in 24 cases were analyzed retrospectively , then the data was transmitted to the workstation and multiplanar reconstruction （ MPR ） , volume rendering （ VR ） , CT virtual endoscope （ CTVE ） and 4D - raysum were performed, The anatomical data of odontoid process in 5 cases were measured preoperatively with screw internal fixation through anterior approach, and CT findings in 16 cases pre - and post - treatment were analysed comparatively, Results Among the 24 patients, according to the criteria delineated by Anderson and D＇ Alonzo,there were type Ⅰ in 1 case,type Ⅱ in 15 cases accompanied with the fracture of the atlas in 2 cases and type ill in 8 cases. 16 cases were treated with Halo external fixation,5 cases and 3 cases were treated with screw internal fixation through anterior approach and posterior approach respectively, Among the 16 post - treatment eases,9 cases and 7 cases were treated with Halo external fixation and internal fixation respectively, the fractures recovered all well. Conclusion MSCT is the first choice examination method in the diagnosis and therapeutic evaluation of odontoid process fractures.

关 键 词：齿状突 骨折 体层摄影术 X线计算机 

分 类 号：R683.2[医药卫生—骨科学] R814.42[医药卫生—外科学]