儿童寰枢关节半脱位X线及多层螺旋CT诊断价值及对比分析

目的：比较颈椎X线与多层螺旋CT扫描在儿童寰枢关节半脱位诊断中的差异。方法：回顾性分析194例临床疑诊为儿童寰枢关节半脱位的影像学检查资料,X线常规检查73例,〈7岁组32例,≥7岁组41例;多层螺旋CT检查121例,〈7岁组63例,≥7岁组58例。比较两组的诊断阳性率。结果：73例常规X线检查,诊断24例（阳性率32.88%）,其中〈7岁组8例（阳性率25%）,≥7岁组16例（阳性率39.02%）;121例多层螺旋CT检查,诊断58例（阳性率47.93%）,其中〈7岁组29例（阳性率46.03%）,≥7岁组29例（阳性率50%）。〈7岁学龄前儿童组,X线与CT的阳性率有明显统计学差意,（P〈0.05）;≥7岁学龄儿童组,X线与CT的阳性率χ2检验无统计学差异（P〉0.05）。结论：〈7岁学龄前儿童,多层螺旋CT对环枢椎半脱位具有重要的诊断价值,≥7岁儿童可依据临床要求选择常规X线或CT检查。

The clinical value and comparison of conventional radiography and MDCT reconstruction in atlantoaxial subluxation in children

Objective： To study the diagnostic value and comparison of conventional radiography and maltideteetor-row computed tomography （MDCT） in atlantoaxial subluxation in children. Methods： The imaging data of 194 children who were suspected to be with atlantoaxial subluxation were analyzed retrospectively. 73 children were examed by conventional radiography of cervical vertebrae, in which 32 cases were younger than 7 years old and 41 cases were equal to or beyond 7 years. Cervical spines of 121 cases were performed by MDCT scan and reconstruction, in which 63 cases were younger than 7 years old and 58 cases were equal to or beyond 7 years. The positive rates of adantoaxial subluxation of different age groups in conventional radiography were compared with those in MDCT reconstruction, respectively. Results：In the 73 eases examed by conventional radiography, 24 cases were diagnosed atlantoaxial subluxation and the positive rate was 32.88%. In the 24 cases, 7 cases （25%） were younger than 7 years old and 16 eases （39.02%） were equal to or beyond 7 years. Atlantoaxial joint of all the 121 eases was revealed dearly, 58 cases were diagnosed aflantoaxial subluxation and the positive rate was 47.93%, in which 29 cases （46.03%） were younger than 7 years old and 29 cases （50%） were equal to or beyond 7 years. Although the positive rates of MDCT reconstruction were all higher than conventional radiography, only in the patients who were younger than 7 years old the positive rate detem：ined with CT and radiography had statistical difference. Conclusion： Conventional radiography is simple and convenient technique for evaluation of atlantoaxial subluxation. MDCT can increase the accuracy and completeness of the diagnosis, and show the complex and muhifracture, and have a complementary diagnostic role in atlantoaxial diseases. In the children who were younger than 7 years old, the positive rate of MDCT reconstruction was higher than conventional radiography.