6排螺旋CT三维重建及血管成像对颅颈交界畸形诊断的研究

6 Three Dimensional Reconstruction of Spiral CT Angiography of the Craniocervical Malformation Diagnosis

目的:研究6排螺旋CT三维重建及血管成像对诊断颅颈交界畸形的价值。材料与方法:18例经手术治疗的颅颈交界畸形患者,术前均做6排螺旋CT检查.并行三维重建,分析椎体骨质的异常情况及椎动脉相互关系。结果:寰枢椎脱位11例(前脱位),寰枕融合12例,齿状突型颅底陷入4例,颈椎融合6例,扁平颅底2例,寰椎前后弓未闭合3例.外伤后齿状突骨折合并寰枢椎脱位2例,外伤后枢椎假关节形成,齿状凸与寰椎前弓相融合2例,齿状突发育不全l例,椎基底动脉供血不足3例,Arnold-chiari畸形9例。结论:6排螺旋CT血管造影结合多种三维重建方法可同时观察骨结构与血管走行及周围软组织关系,能够正确诊断并能发现少见的畸形.对于颅颈交界区畸形患者手术方案及手术入路的选择是非常重要的临床应用价值。

Purpose：Of 6 three-dimensional reconstruction of spiral CT and angiography in the diagnosis of craniocervical malformations.Materials and Methods：18 Cases with surgical treatment of craniocervical malformation patients preoperatively to do 6-slice spiral CT.Parallel three-dimensional reconstruction of abnormal vertebral bone and vertebral artery relationship.Results：Atlantoaxial dislocation in 11 cases（before dislocation）,12 cases of occipitocervical fusion,odontoid type base of the skull into 4 cases,6 cases of cervical fusion,flat base of the skull in 2 cases,before and after the arch of atlas is not closed in 3 cases.Post-traumatic odontoid fractures with atlantoaxial dislocation,2 case of Post-traumatic atlantoaxial pseudoarthrosis,dentate convex anterior arch of atlas and the integration 2 cases,of dens hypoplasia l cases of vertebrobasilar insufficiency in 3 cases,Arnold-chiari malformation in 9 cases.Conclusion：6-slice spiral CT angiography combined with a variety of three-dimensional reconstruction method can simultaneously observe the bone structure and soft tissue around the blood vessels course and relationship to diagnosis and to find rare malformation.For patients with craniocervical junction malformations surgical plan and surgical approach of choice is a very important clinical value.