类风湿关节炎寰枢关节滑膜病变的影像表现及鉴别诊断

发布时间：2018-03-08 18:32

本文选题：类风湿关节炎　切入点：寰枢关节　出处：《临床放射学杂志》2017年03期 　论文类型：期刊论文

【摘要】：目的探讨类风湿关节炎(RA)寰枢关节侵犯的影像表现。方法对临床确诊的16例伴寰枢椎侵犯RA患者的CT和MRI影像表现进行回顾性分析,包括RA骨侵犯部位、类型、寰枢关节受累情况、是否合并寰枢关节不稳定、脱位及脊髓压迫。结果RA骨质侵犯部位主要集中于齿状突、前弓和侧块;寰枢外侧关节和寰枢正中关节受累概率相同为56%,寰枕关节受累为25%;9例合并寰枢椎前脱位,4例合并垂直脱位及颅底凹陷;11例寰齿关节滑膜增生明显,1例合并假瘤;10例合并C_(1~2)水平脊髓压迫并脊髓变性;寰齿关节脱位与滑膜增生和骨质侵蚀的相关系数分别为0.2和0.4。结论RA侵犯脊柱以上颈椎即寰枢椎为主,寰枢外侧关节和寰枢正中关节受累可导致寰枢椎脱位、颅底凹陷及脊髓压迫。
[Abstract]:Objective to investigate the rheumatoid arthritis (RA) imaging findings of atlantoaxial joint involvement. Methods the clinical diagnosis of 16 cases with atlantoaxial joint infringement of CT and MRI imaging of RA were retrospectively analyzed, including the RA bone invasion site, type of atlantoaxial joint involvement, whether combined with atlantoaxial instability and dislocation. Spinal cord compression. Results RA bone invasion area mainly concentrated on the odontoid process, the anterior arch and the lateral mass; lateral atlantoaxial joint and median atlantoaxial joint involvement in the same probability is 56%, the atlanto occipital joint involvement for 25%; 9 cases with atlantoaxial anterior dislocation, dislocation and vertical basilar invagination in 4 cases; 11 cases of synovial atlas odontoid joint hyperplasia, 1 cases with false aneurysm; 10 cases with C_ (1~2) level of the spinal cord and spinal cord degeneration; atlanto odontoid joint dislocation and synovial hyperplasia and bone erosion of the correlation coefficients were 0.2 and 0.4. more than that of cervical spine involvement conclusion RA atlantoaxial, atlanto axial The involvement of the lateral joint and the median joint of the atlantoaxial joint can lead to atlantoaxial dislocation, the depression of the skull base and the compression of the spinal cord.

【作者单位】：北京大学第三医院放射科;山东临沂市人民医院放射科;
【分类号】：R593.22;R816.8;R445.2

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