多层螺旋CT诊断环杓关节脱位的价值

目的：探讨多层螺旋CT对环杓关节脱位的诊断价值。方法：28例声嘶患者，均经纤维喉镜检查发现单侧声带麻痹。在平静呼吸及Valsalva呼吸状态下，分别行喉部多层螺旋CT扫描，层厚为0．625mm，并在工作站(ADW4．0)进行环杓关节、声带、喉部含气腔的3D容积重建。环杓关节复位治疗后CT复查23例。结果：28例患者多层螺旋CT轴位及各种重建图像显示喉部结构不对称。杓状软骨前脱位16例，后脱位12例，左侧19例，右侧9例。声带固定于旁中位伴同侧梨状窝扩大26例，固定于中位伴梨状窝缩小2例。复位治疗后23例复查喉部CT，18例环杓关节显示正常。结论：多层螺旋CT及3D容积重建能清晰显示环杓关节脱位的病变特征，对环杓关节脱位诊断与复位治疗具有重要的临床价值。

Application of multi-slices spiral CT in diagnosis of cricoarytenoid joint dislocation

Objective:To evaluate multi-slices spiral computed tomography (MSCT) in diagnosing crico aryrenoid joint dislocation.Methods:28 patients with hoarseness and lateral vocal cord paralysis suspected with crico arytenoid dislocation were imaged with MSCT.Twice volume scans were performed in all patients during quiet breath and Valsalva breath respectively at thickness 0.625mm.Volume-rendering (VR) images were gained on the workstation. Among them, 23 cases were imaged with MSCT after repositioning.Results:The asymmetric structures of larynx were showed in all patients on the axial and reformatted images,which revealed that anterior and post arytenoid dislocation were in 16 cases, 12 cases,respectively, left arytenoid dislocation 19 cases, right arytenoid dislocation 9 cases.The paralyzed vocal cord fixed at paramedian position accompanying with enlargement of the ipsilateral pyriform sinus were found in 26 cases, while 2 cases with diminution of the ipsilateral pyriform sinus.18 cases of the normal cricoarytenoids joints were showed after repositioning.Conclusion:MSCT and 3D-VR might demonstrate clearly the features of the arytenoid dislocation and it may be a useful adjunct in the diagnosis and repositioning of arytenoid dislocation.