非创伤性寰枕关节失稳的CT表现及相关因素分析  

Nontraumatic Occipitoatlantal Instability:CT Findings and Related Factor Analysis

作　　者：许亮[1] 刘筠[1] 佟帆[2] 杨筠[1] 钟进[1] 

机构地区：[1]天津市人民医院影像学部,300121 [2]天津市人民医院康复科,300121

出　　处：《临床放射学杂志》2008年第11期1531-1534,共4页Journal of Clinical Radiology

基　　金：天津市自然科学基金资助项目(编号:05YFMJC07700)

摘　　要：目的探讨非创伤性寰枕关节失稳的CT表现。资料与方法回顾性分析182例颈椎CT平扫患者资料,原始图像经后处理工作站行多平面重组(MPR),重点观察寰枕关节形态和关节失稳的CT表现。结果21例(11.54%)寰枕关节失稳患者均无明确外伤史,其中单侧枕骨髁后旋转型失稳13例,单纯后移位型失稳5例,后移位-旋转复合型失稳3例。矢状面MPR均表现为关节前缘骨皮质连线向后角折,关节面呈阶梯状改变,7例冠状面MPR示双侧寰枕关节同向错动;11例横断面MPR示"窄三角形间隙征"。15例显示寰椎上关节突后部平坦。结论薄层螺旋CT扫描并MPR技术可充分显示寰枕关节的形态学特征,寰椎上关节突后部平坦和矢状面MPR枕骨髁向后移位超过2mm是诊断寰枕关节失稳的重要征象。Objective To discuss the CT findings of no traumatic occipitoatlantal instability. Materials and Methods 182 consecutive patients with neck CT were included, sagital, coronal and axial images were obtained with MPR technique, CT findings of shape and oecipitoatlantal instability were observed. Results 21 patients without cervical traumatic history were divided into 3 different types instability according to the translation direction of condyle. 13 condyles appeared posterior translation on atlas ,5 patients showed unilateral condyle rotated on the atlas, and other 3 cases appeared posterior translation associated with axial rotatory. It was the typical findings that the anterior bone margine of occipitoatlantal joint stepped posteriorly at the space level in sagital image（ n = 21 ）, other important findings included lateral bone margine of joint shift to the same direction in coronal image（ n = 7 ）, narrow space between arch anterior atlantis and condyle in axial image（ n = 11 ）, flatten in posterior part of superior atlantal facet （ n = 15 ）. Conclusion CT spiral scan with muhiplanar reformation has a great role in detecting the morphology alteration. Flatten in posterior part of superior atlantal facet and translated more than 2 mm posteriorly of occipital condyle are the typical findings of oecipitoaflantal instability.

关 键 词：体层摄影术 X线计算机 寰枕关节 失稳 非创伤性 

分 类 号：R816.8[医药卫生—放射医学]