小儿颈椎及颈脊髓损伤的影像学诊断

Imaging Diagnosis of Cervical Spine and Spinal Cord Injuries in Children

总结小儿颈椎及颈脊髓损伤的影像学诊断经验。回顾分析 59例小儿颈椎及颈脊髓损伤 ,全部病例均常规摄颈椎正、侧位片及齿状突开口位片 ,2 5例摄断层 ,2 8例摄屈 /伸侧位片。 2 1例行CT扫描 ,2 6例行MRI检查。上颈椎损伤 4 6例 ,其中寰椎椎弓骨折 9例 ,枢椎骨折 7例 ,齿状突骨折 2 1例 ,寰椎椎弓骨折合并齿状突骨折 1例 ,寰椎横韧带断裂 8例 ;下颈椎损伤 1 1例 ,其中椎体骨折 3例 ,脱位 2例 ,骨折脱位 6例 ;多节段间隔性颈椎损伤 2例 ,无X线异常的脊髓损伤 (SCIWORA) 3例。认为影像学检查对于小儿颈椎及颈脊髓损伤的诊断具有重要价值 ,对怀疑有颈椎及颈脊髓损伤的小儿患者应常规摄颈椎正、侧位片及齿状突开口位片 。

This study is designed to provide the experience in imaging diagnosis of cervical spine and spinal cord injuries in children The routine radiography including the lateral,anteroposterior and open-mouth odontoid views were performed in all patients Tomography was available from 25 patients,and flexion-extension lateral views,28 patients,CT scan,21 patients,MRI,26 patients Of these patients,46 patients were identified with injuries of upper cervical spine(nine with atlantal arch fracture,seven with axial fracture,21 with odontoid fracture,one with atlantal arch fracture combined odontoid fracture,and one with atlantal transverse ligament disruption),eleven patients sustained injuries of lower cervical spine(three fractures of vertebral body,two dislocations and six fracture-dislocations),two patients had multiple noncontiguous cervical injuries,and three had cervical spinal cord injury without radiographic abnormalities (SCIWORA) Authors consider that imaging assessment is of great importance to diagnose of cervical spine and spinal cord injuries in children Whenever cervical spine and spinal cord injuries were suspected for childish patients,the three-views should be routinely indicated MRI should be routinely performed in all childish patients with cervical SCIWORA