颅底凹陷症伴寰枢椎脱位手术前后螺旋CT对颈枕区骨性径线测量价值  

Value of multi-slice CT in measurement of cervico-occipital bone diameter before and after surgery for basilar invagination with atlantoaxial dislocation

作　　者：戴伟英[1] 田超[1] 杨天昊[1] 任涛 DAI Wei-ying;TIAN Chao;YANG Tian-hao;REN Tao(Department of Radiology,Huan Hu Hospital,Tianjin 300350,China)

机构地区：[1]天津市环湖医院医学影像科

出　　处：《中国临床医学影像杂志》2019年第9期651-655,共5页Journal of China Clinic Medical Imaging

摘　　要：目的:探讨MSCT对评价成人颅底凹陷症伴寰枢椎脱位手术效果的价值。方法:根据本研究确定入选标准共选取患者37例,所有患者皆来自我院入院患者,经临床确诊为成人颅底凹陷症伴寰枢关节脱位,于我院接受手术治疗,手术前后行影像学检查,分析其MSCT三维重组图像,依据患者是否伴有脊髓空洞,将患者分为2组,A组不伴脊髓空洞,B组伴脊髓空洞。应用测颅法获取BDI、ADI、SAC、CCA、HI、CBL数据。对比手术前后各项指标,分析发生的变化,同时记录手术疗效。应用统计软件进行分析,获得相关结果。结果:A组手术前后BDI、ADI、SAC、CCA、HI、CBL分别为12.6、8.3mm,4.5、3.3mm,18.2、20.8mm,138.3°、150.4°,28.7、43.4mm,6.3、3.3mm,JOA评分手术前后分别为8.87、12.6分。有统计学差异(P<0.05);有效和稳定分别为12例和3例。手术前后JOA评分与各指标显著相关(r值-0.667、-0.673,-0.771、-0.719,0.682、0.625,0.595、0.658,0.787、0.696,-0.647、-0.796;P<0.05)。B组手术前后BDI、ADI、SAC、CCA、HI、CBL分别为12.2、8.6mm,5.9、3.1mm,16.3、17.6mm,136.8°、150.2°,32.3、41.5mm,8.7、4.8mm,JOA评分分别为9.59分、13.59分,有统计学差异(P<0.05)。有效和稳定者分别20例和2例。手术前后JOA评分与各指标有显著相关(r值-0.756、-0.728,-0.651、-0.619,0.684、0.672,0.726、0.695,0.578、0.632,-0.748、-0.821)。结论:MSCT测量有助了解手术前后骨性结构变化,可以用于判断疗效。Objective:To explore the value of MSCT in evaluating the surgical effect of adult basilar invagination with atlantoaxial dislocation.Methods:Thirty-seven patients with basilar invagination and atlantoaxial dislocation underwent imaging examination before and after operation.MSCT three-dimensional reconstructed images were analyzed.According to the presence or absence of syringomyelia(SM),the patients were divided into two groups(group A without SM,group B with SM).The data of basion-dens interval(BDI),atlanto-dental interval(ADI),space available for the spinal cord(SAC),clivus-canal angle(CCA),highly index(HI),and chamberlain line(CBL)of the occipitocervical were obtained by craniometry.The differences of these parameters before and after operation were compared,and the correlation between these parameters and the clinical effect were analyzed.Results:In group A,the BDI,ADI,SAC,CCA,HI and CBL before and after operation were 12.6 mm,8.3 mm,4.5 mm,3.3 mm,18.2 mm,20.8 mm,138.3°,150.4°,28.7 mm,43.4 mm,6.3 mm,3.3 mm respectively,and the JOA scores were 8.87 points and 12.6 points before and after surgery,with statistical difference(P<0.05).There were 12 effective cases and 3 stable cases after surgery in group A,the JOA scores before and after operation were significantly correlated with each index(r=-0.667,-0.673,-0.771,-0.719,0.682,0.625,0.595,0.658,0.787,0.696,-0.647,-0.796;P<0.05).In group B,the BDI,ADI,SAC,CCA,HI and CBL before and after surgery were 12.2 mm,8.6 mm,5.9 mm,3.1 mm,16.3 mm,17.6 mm,136.8°,150.2°,32.3 mm,41.5 mm,8.7 mm,4.8 mm respectively,and the JOA scores were 9.59 points and 13.59 points before and after surgery,with statistical difference(P<0.05).There were 20 effective cases and 2 stable cases after surgery in group B,and JOA scores before and after operation were significantly correlated with each index(r=-0.756,-0.728,-0.651,-0.619,0.684,0.672,0.726、0.695,0.578,0.632,-0.748,-0.821 respectively,P<0.05).Conclusion:MSCT measurement is helpful to understand the changes of bone structure befor

关 键 词：肌肉骨骼畸形 颅底 体层摄影术 螺旋计算机 

分 类 号：R682.11[医药卫生—骨科学] R814.42[医药卫生—外科学]