急性寰枢关节损伤CT征象研究与临床应用价值探讨

Study of CT Diagnossis and Clinical Application Value to the Acute Joint Damage of Axis and Atlas

目的:研究急性寰枢关节损伤CT征象,探讨其CT诊断与临床应用价值。方法:共47例,采用2 mm层厚和间隔行寰、枢椎(含寰枢关节)薄层CT扫描,3例行平扫后增强CT扫描,部分病例进行冠状位、矢状位及三维图象重建,观察骨折情况及椎管内、椎旁损伤受累细节,测量寰枢关节前间隙宽度及齿状突偏移度。结果:13例共见19处骨折,部位分别为齿状突、寰椎侧块、枕骨、枢椎椎板、棘突等,寰枢关节脱位23例,其中单纯性脱位16例,旋转性半脱位7例,11例合并椎旁血肿,2例见椎动脉受压,5例继发性椎管狭窄。结论:CT具有快捷、安全、密度分辨率高等优点,可明确急性寰枢关节损伤细节,对制定治疗方案及估价预后具有重要作用。

Objective：To study CT features of acute joint damage of axis and atlas and discuss its diagnosis and clinical values. Methods：To all the 47 cases ,CT scans were applies with 2mm thick and gap to axis and atlas. 3 cases were tnhanced after normal scanning, some cases were given Coronal and Sagittal 3 D constructions to observe the bone broken conditions and the details of vertebral canal,near side tissue. The front suture width of axis and atlas joints and the shift degree of dens were also measured. Results： 13 cases with 19 bone broken points,the positions are at dens ,side plank of atlas,occipital,plank of axis,processus spinosus etc. 23 cases with axis and atlas half dislocation. Of which, 16 cases were with pure dislocation,7 cases with rotating dislocation, 11 cases were with swollen at the side of vertebra,2 cases with depressing of vertebral artery,5 cases with continued narrowing of vertebral canal. Conclusions： CT has the advantage of quickness, safety and high density discerning, it can reveal details of acute axis and atlas damages, so it has great importance to treatment scheme making and to the prognosticate.