正常成人寰枢关节齿突偏移及关节间隙的螺旋CT测量研究

目的通过CT图像测量正常成人寰枢关节齿突偏移及关节间隙数据获取其正常参数,为临床判断有无寰枢关节异常提供参考标准。方法对正常成人146例无寰枢关节病变的健康志愿者分A组(18～29岁),B组(30～49岁),C组(≥50岁)3个年龄组,男70例女76例,均行常规中立位螺旋CT扫描寰枢椎体,对原始图像应用图像后处理工作站的多平面重组(MPR)软件功能进行处理后,测量齿状突齿突生长性偏移值(DO)、寰齿前间隙(ADI)、寰齿侧块间隙(LADI)、双侧齿突侧块间距差(VBLADI)、齿突侧块间隙差值比(RVBLADI)。结果正常成人齿状突生长性偏移平均为0.256±0.444,偏移62人,偏移率:42.5%,最大偏移值:2mm;寰齿前间隙(ADI)平均值为(1.70±0.47)mm,齿侧间隙差值(VBLADI)平均为(0.707±0.742),齿侧间隙差值比率(RVBLADI)平均为(0.045±0.0457)。ADI值A组>B组>C组,A组中96%的ADI为1.2～3mm,B岁组中98%的为ADI为1.2～2.5mm,C组中98%的为ADI0.5～2mm;双侧LADI不对称发生率77.39%,其VBLADI及RVBLADI值A组>B组>C组,不对称组中18-29岁组92%的VBLADI值范围是0.2～3mm、RVBLADI的范围是1.1%～18%,30-49岁组95%的VBLADI值的范围是0.1～2mm、RVBLADI的范围是1.2%～14.2%,≥50岁组97%的VBLADI的范围是0.2～1.5mm、RVBLADI的范围是1.2%～9%。结论标准中立位寰枢关节CT扫描及多平面重组能够全面观察寰枢椎影像解剖的结构,提供正常成人CT影像学DO及各年龄段的ADI、VBLADI、RVBLADI的正常参考值数据,为寰枢关节脱位或半脱位提供依据。

The Spiral CT Metrical Study of Atlantoaxial Joint Tooth Axon Migration and Joint Space in Normal Adults

Objective In order to obtain the normal parameters, we use CT images to measure the normal adult atlantoaxial joint tooth axon migration and,joint space of the spiral, these data can be the reference standard for clinical judgment whether the atlantoaxial joint abnonualities. Methods First, 146 cases of no atlantoaxial joint lesions in healthy adult volunteers were divided into three groups： group A （ 18 to 29 years old）, group B （30 to 49 years old）, group C （more than 50 years）, including 70 men and 76 women, underwent conventional neutral spiral CT scan of the atlantoaxial vertebral, and then use the multi-planar reconstruction （MPR） sol）ware to deal with the original image, finally get the odontoid g,owth offset value （DO）, the former atlantoodontoid gap （ADI）, atlantoodontoid side of the block gap （LADI）, bilateral odontoid lateral mass spacing difference （VBLAD1）, odontoid lateral mass gap difference ratio （RVBLADI）. Results In the 146 volunteers, the odontoid growth offset value is 0.256 ± 0.444, offset 62, offset rate： 42.5%, the maximum offset value： 2mm： the average of former atlantoodontoid gap （ADI）, bilateral odontoid lateral mass spacing difference （VBLADI） and odontoid lateral mass gap difference ratio （RVBLADI） are （ 1.70 ± 0.47 ） mm. （0.707 ± 0.742） mm, （0.045 ± 0.0457） mm. ADI is group A 〉 group B〉 group C L-In group A, 96% of the ADI is 1.2 - 3mm, 92% of the VBLADI is 0.2 - 3mm, RVBLADI range is 1.1%- 18%. In group B. 98% of the ADI is 1.2 - 2.5mm, 95% of the VBLADI is 0.1 - 2mm. RVBLADI range is 1.2%-14.2%. In group C, 98% of the ADI is 0.5 2mm, 97% of the VBLADI is 0.2-1.5mm, RVBLADI range is 1.2%-9%. The rate of LADI pair side asymmetry is 77.39%. Conclusion The standard neutral position of the atlantoaxial joint CT scan and multiplanar reconstruction can fully observe the structure of the atlantoaxial image anatomy, for normal adult CT imaging DO and age of the ADI. VBLADI, RVBLADI provide normal reference value data, and for atlantoaxial dislocation or subluxation provide the basis.