外伤性寰枢关节旋转固定的多排螺旋CT影像诊断分析  

Multi-slice spiral CT imaging diagnosis of traumatic atlantoaxial joint rotary fixation

作　　者：何宏伟[1] 胡佰文[2] 王维 

机构地区：[1]宁波市第一医院放射科,浙江宁波315010 [2]宁波市第一医院骨科,浙江宁波315010 [3]宁波市中医院放射科,浙江宁波315010

出　　处：《中国现代医生》2016年第36期124-127,共4页China Modern Doctor

基　　金：浙江省宁波市自然基金课题(2015A610304)

摘　　要：目的研究外伤性寰枢关节旋转固定的CT影像特点。方法回顾性分析经影像和临床证实的8例外伤性寰枢关节旋转固定患者的影像资料,分析其多排螺旋CT影像特点;测量寰齿前间隙(atlantodental interval,ADI)以及双侧寰齿侧间隙(odontoid lateral mass interval,OLMI)不对称值。另随机选取因颈部外伤来院经影像和临床证实的无寰枢关节异常及颈椎骨折的60例患者为对照组,测量对照组的ADI、OLMI不对称值。结果 8例外伤性旋转固定中,发现FieldingⅠ型4例,Ⅱ型4例;ADI为(3.3±1.3)mm,其中Ⅰ型ADI(2.3±0.5)mm,Ⅱ型ADI(4.3±0.8)mm;双侧OLMI不对称值(odontoid lateral mass interval asymmetry,OLMIA)为(2.7±2.0)mm。对照组ADI为(1.5±0.4)mm,OLMIA为(0.8±0.7)mm,两组比较,差异有统计学意义(P<0.05)。结论多排螺旋CT的多平面重建(multiple planar reconstruction,MPR)技术可以很好地显示外伤性寰枢关节旋转固定及其伴有的寰枢椎骨折。OLMI不对称现象在人群中普遍存在,诊断外伤性寰枢关节旋转固定需结合其他影像征象及临床症状。Objective To study the CT imaging features of traumatic atlantoaxial joint rotary fixation. Methods The imaging data of 8 patients with traumatic atlantoaxial joint rotary fixation confirmed by imaging and clinical manifestations were analyzed retrospectively. And the characteristics of multi-slice spiral CT were analyzed.The atlantodial interval （ADI） and the odontoid lateral mass（OLMI） asymmetry were measured. 60 patients with no atlantoaxial joint abnormalities and cervical fractures confirmed by imaging and clinical manifestations, who were admitted in our hospital caused by neck trauma, were randomly selected as the control group. The ADI and OLMI asymmetry of the control group were measured. Results In the 8 cases of traumatic rotational fixation, 4 cases of Fielding I type and 4 cases of type Ⅱ were found. ADI in the observation group was（3.3±1.3） mm, including type Ⅰ ADI （2.3±0.5） mm, type Ⅱ ADI （4.3±0.8） mm, and the odontoid lateral mass interval asymmetry was （2.7±2.0） mm. ADI was （1.5±0.4） mm and OLMIA was （0.8±0.7） mm in the control group. There was significant difference in ADI between the two groups. Conclusion Multiple planar reconstruction （MPR） technique of multi-slice spiral CT can be used to show the rotational fixation of traumatic atlantoaxial joint and its related atlantoaxial fracture. OLMI asymmetry phenomenon is prevalent in the crowd, so the diagnosis of traumatic atlantoaxial joint rotary fixation need to be combined with other imaging signs and clinical symptoms.

关 键 词：寰枢关节 旋转固定 半脱位 不对称 

分 类 号：R684.7[医药卫生—骨科学]