成人寰枢正中关节间隙正常值的CT多平面重组测量

Reference ranges for atlanto-dental interval in adults on midsagittal image by multi-planar reconstruction of computed tomography

目的：测量MSCT影像成人寰枢正中关节间隙（ MADI）的正常值范围,探讨MADI值与年龄和性别的关系。方法选取2009年8月—2014年7月山东省医学影像研究所18岁以上行寰齿关节MSCT扫描的700例患者影像资料行回顾性分析,排除外伤、累及上颈椎各类疾病者,按年龄分为18-24岁、25-29岁、30-39岁、40-49岁、50-59岁、60-69岁和≥70岁7组,每组入选100例。对寰齿关节正中矢状位CT影像进行多平面重组,并测量寰椎前后结节中点连线经过寰齿关节间隙的长度,即MADI。计算不同年龄组患者MADI值,并采用线性回归方法进一步分析MADI值与年龄、性别的关系。结果7组由低至高不同年龄患者的MADI值依次为（1.77±0.39）mm、（1.61±0.37）mm、（1.58±0.36） mm、（1.41±0.29） mm、（1.34±0.28）mm、（1.31±0.29） mm、和（1.06±0.47）mm,MADI随年龄增加而递减（r=-0.511, P＜0.01）。男性MADI（1.50±0.36）mm,女性MADI（1.38±0.34）mm,MADI 在不同性别之间无相关性（r=0.000, P＞0.05）。结论在MSCT正中矢状位上MADI值与年龄呈负相关,与性别无关。

Objective To evaluate the reference ranges of atlanto-dental interval（MADI）in a large sample of adult patients on MSCT, and to analyze the relationships of these measurements with gender and age of the patients.Methods A consecutive series of 700 Chinese patients aged〉18 years undergoing an upper cervical MSCT scan were divided equally into seven age groups：18-24, 25-29, 30-39, 40-49, 50 -59, 60 - 69, ≥70 years, respectively. Using the post-processing technique of multi-planar reformats, the midsagittal image of the atlanto-dental joint was chosen for measurement and MADI was defined as the distance intercepted from the segment line linking the center of anterior atlas tubercle with that of posterior tubercle. The correlation of MADI with age and gender was analyzed using linear regression analysis.Results The MADIs were（1.77±0.39）mm,（1.61±0.37）mm,（1.58±0.36）mm, （1.41±0.29）mm,（1.34±0.28）mm,（1.31±0.29）mm,and（1.06±0.47）mm in the age groups 18-24 years, 25-29 years, 30-39 years, 40-49 years, 50-59 years, 60-69 years, and older than 70 years, respectively. MADI decreased linearly with age （r= -0. 511, P〈0. 01）. The MADI of male was （1. 50 ± 0. 36） mm. The MADI of female was （1. 38 ± 0. 35） mm. There was no difference between different genders（r=0.000,P〉0.05）.Conclusions MADI measurements on MDCT decrease linearly with age, and these are not affected by gender in adult patients.