寰枢椎旋转性半脱位的诊断

Diagnosis of Altanto-Axial Rotatory Subluxation

目的 :探讨X线检查 ,螺旋CT扫描以及三维影像重建在诊断寰枢椎旋转性半脱位的不同临床意义。方法 :2 4例行颈椎张口位片检查 ,其中 16例和 5例对照组采用螺旋CT扫描。结果 :平均 5 0 %以上 2次摄片 ,部份齿状突与侧块间距显示不清。 16例螺旋CT扫描均证实齿状突与寰椎侧块间距不等。三维影像重建立体地再现寰枢椎旋转性半脱位的移位程度和齿状突发育情况。 5例对照组正常。结论 :常规X线多能确诊。螺旋CT扫描及三维影像重建 ,可弥补诊断上的困难 ,同时也有利于指导治疗。

Objective: To discuss the difference of clinical significance with roentgenograms of the cervical spine, spiral CT and three dimensional imaging reconstruction in the diagnosis of altanto-axial rotatory subluxation. Methods: Twenty-four patients were examinated by an open-mouth roentgenography, 16 of them and 5 controls by spiral CT. Results:More than 50% patients were averagely roentgenograpied again, parts of which shows not clear on odontoid and lateral mass. 16 of them may be displaied the difference of intervals between odontoid and lateral mass by spiral CT, 5 controls being normal. Three dimensional imaging reconstruction shows stereogram of the displacement degree of altanto-axial rotatory subluxation and the development of odontoid. Conclusion: Diagnosis may be mostly made by routine roentgenograms. It made up for the difficult of diagnosis by spiral CT and three dimensional imaging reconstruction, which be helpful to guide treatment at the same time.