影像学检查诊断寰枢关节不全脱位的临床价值

目的:比较寰枢关节影像学检查的优缺点,评价影像检查诊断寰枢关节不全脱位的临床价值。方法:回顾性分析X线摄片52例、常规CT检查69例、MRI检查7例、CT三维成像检查89例患者寰枢关节的影像资料。观察寰枢关节不全脱位的影像学表现,分析其临床价值及特点。结果:X线检查52例,肯定脱位诊断13例、可疑脱位诊断17例、无脱位诊断22例。常规CT检查69例,肯定脱位诊断32例、可疑脱位诊断23例、无脱位诊断14例。MRI检查7例,肯定脱位诊断1例、可疑脱位诊断3例、无脱位诊断4例。CT三维成像检查89例,肯定脱位诊断72例、可疑脱位诊断0例、无脱位诊断17例,其肯定脱位诊断率为80.9%,旋转性脱位诊断率为72.2%。结论:影像学检查是诊断寰枢关节不全脱位的主要方法,具有确定诊断的临床价值。其中CT三维成像显示脱位征象最清楚、直观。

Clinical value of imaging examination in diagnosing atlantoaxial subluxation

Objective: To compare the features of imaging examination in the atlantoaxial joints, and evaluate imaging examination in diagnosing atlantoaxial subluxation. Methods: Fifty-two cases were examined by plain X-ray, 69 by routine CT, 7 by MRI, and 89 by CT three-dimensional(3D) imaging. Their imaging findings in diagnosing atlantoaxial subluxation were retrospectively analyzed, their imaging manifestations were observed and the imaging diagnosis obtained. 3D-images were mainly obtained by surface shade display(SSD), assisted with multiplanar reformorting(MPR), maximum intensity projection(MIP) and volume rendering(VR). Results: In the 52 cases examined by X-ray examination, there were 13 cases with dislocation, 17 cases were suspicious and negative in 22. In the 69 cases examined by routine CT, 32 cases had dislocation, suspicious in 23 and negative in 14. In the 7 cases examined by MRI, 1 case had dislocation, suspicious in 3 and negative in 4. In the 89 cases examined by CT-3D reconstruction, 72 cases had dislocation and negative in 17. Its positive diagnostic rate of dislocation and diagnostic rate of rotary dislocation is 80.9% and 72.2% respectively. Conclusion: Imaging examinations are the main methods in diagnosing atlantoaxial subluxation, and can be used in ascertaining diagnosis. 3D-CT shows the signs of atlantoaxial dislocation most clearly and directly.