螺旋CT3D重建对寰枢关节不全脱位的诊断价值

目的评价螺旋CT三维（CT3D重建诊断寰枢关节不全脱位的临床价值。方法回顾性分析临床确诊寰枢关节不全脱位69例患者的三维影像特点及诊断结果。并比较多层面重建（MPR）、表面遮盖显示（SSD）、最大密度投影（MIP）及容积重建（VR）显乐寰枢关节结构及病变的优缺点。结果三维CT重建诊断寰枢关节不全脱位69例，诊断符合率100％，其中，旋转脱位37例，后脱位18例，前脱位14例，脱位合并骨折10例，显示寰枢关节上、下关节面错位69例，寰齿间隙增宽36例及齿突侧距不对称31例，并骨折29例？与MPR或MIP比较，VR与SSD法三维图像显示征象最直观清楚。结论CT3D重建能直观显示脱位的各种征象，准确诊断寰枢关节不全脱位的类型及脱位程度，为临床诊断及治疗提供客观依据。

Clinical value of spiral CT 3D reconstruction in diagnosing atlantoaxial subluxation

Objective To evaluate the clinical value of spiral CT 3D reconstruction in diagnosing atlantoaxial sabluxation.Methods 3D reconstruction findings of 69 patients with clinically proven atlantoaxial subluxation were analyzed retrospectively,and comparisons were made among images of muhiplanar reformatting （MPR）,surtaee shaded display（SSD）.maximum intensity projection （MIP）,and volume rendering （VR）in visualizing the anatomy structures and pathologie changes of atlantnaxial joints. Results Spiral CT 3D reennstruction eorreetly diagnosed all the 69 patients with atlantoaxial subluxation with 100% of accuracy,of whom,37 belonged to rotary disloeation,18 poslerior disloeation,14 anterior disloeation,and 10 associated with fracture.All the 69 eases appeared the dislocated joint plane of atlantoaxial articulation.Thirty-six cascs appeared widened distante between the dens process and anterior arch of the atlas.Thirty-one cases appeared asymmetrie lateral distance of dens process,and 29 cases associated with fracture,The dislocated joint plane of atlantoaxial artieulation was more clearly seen with VR or SSD-3D imaging than other methods.Conclusion Spical CT 3D reeonstruetion can directly reveal the various dislocated signs arid the type arid extent of atlantoaxial subluxaton. thus it ean provide the reliable evidence for clinical diagnosis and treatment.