环枢椎脱位的CT及平片诊断

目的：研究环枢椎脱位平片及ＣＴ表现，比较它们的诊断价值。方法：２０例正常人，１３例环枢椎脱位和２例旋转性半脱位。均作常规ＣＴ扫描，５例加作功能性的ＣＴ扫描。结果：１５例环枢椎脱位和半脱位，平片诊断１５例，ＣＴ诊断１４例，漏诊１例。ＣＴ除显示环枢椎脱位外，还清楚显示合并的椎体多发性骨折部位、范围、骨性椎管的大小及畸形。结论：平片及ＣＴ均是诊断环枢椎病变的重要手段。平片难以显示复杂性骨折及骨性椎管形态的改变；ＣＴ对无移位的齿状突骨折和轻度环枢椎脱位不敏感。功能性的ＣＴ扫描是鉴别生理性和病理性环枢椎脱位的有效方法。

CT and Plain Film Diagnosis of Atlantoaxial Dislocation

Objective:To study the appearence of atlanto-axial dislocation with conventional plain film and CT,and to compare their diagnostic value.Methods:20 normal subjects, 13 cases with atlantoaxial dislocation(AAD) and 2 cases with ratatary atlantoaxial subdislocathon were exammated with rutine CT and X-ray film and 5 subjucts with functional CT scan in addition.Results:15 cases with AAD and ratatary atlantoaxial subdislocathon are all found by X-ray,and by CT but one case.Besides the atlantoaxial dislocation,multiple and complex fractures and deformity bony spinal canal could be properly foumd with CT.Conclusion:X-ray film and CT were all good methods in finding atlantoaxial lesions.However,it was difficult for X-ray film to find out complex fracture and the changes of the bony spinal canal.Odontoid fracture could not be shown with CT if without atlantoaxial dislocation.Functional CT scan is an effective method in differentiating physiological and patholgical ratatary atlantoaxial subdislocation.