结扎兔寰枢关节后部静脉丛前后脊髓MRI特点和寰枢外侧关节部影像学测量

发布时间：2018-06-04 05:27

本文选题：寰枢关节 + 椎动脉　；参考：《青岛大学》2014年硕士论文

【摘要】：目的：探讨经颈后正中入路一次完成寰枢关节松解、复位、内固定融合治疗难复性寰枢椎脱位的理论可行性。方法： 1.通过MRI对实验动物术前及术后各时间寰椎上缘至枢椎下缘脊髓进行扫描,测量各时间段脊髓面积的大小和矢状面图像上T1WI、T2WI相对信号强度,并对各时间段测量数据进行对比分析。 2.根据2012年3月—2013年3月行颈部CT血管造影并符合入选标准的227例患者扫描数据,对椎动脉寰枢关节部的走形与变异、寰椎下关节面部骨性结构、枢椎上关节面部骨性结构进行三维测量与分析。结果： 1.实验动物术前脊髓面积,T1WI、T2WI相对信号强度与术后各时间相比较均无显著性差异(P0.01)。 2.椎动脉在寰枢外侧关节部常形成4个恒定连续的弯曲及存在4种变异类型。左右侧寰枢外侧关节部椎动脉直径、椎动脉沟底部后弓的宽度和高度、枢椎上关节面外倾角、横突孔外倾角及椎动脉压痕比较,差异均具有统计学意义(P0.05)。结论： 1.结扎实验动物寰枢外侧关节部静脉丛前后,不影响寰椎上缘至枢椎下缘脊髓血供,不会引起脊髓损伤的发生。 2.通过颈部血管CT及三维重建对寰枢外侧关节部结构的观察和测量,可以为经颈后正中入路行寰枢外侧关节部松解、复位、内固定融合提供理论依据。
[Abstract]:Objective: to investigate the theoretical feasibility of atlantoaxial joint release, reduction and internal fixation fusion in the treatment of irreducible atlantoaxial dislocation through the posterior cervical approach. Methods: 1. The spinal cord from the upper edge of atlas to the lower edge of axis was scanned by MRI before and after operation. The size of the spinal cord and the relative signal intensity of T1WIN T2WI on sagittal images were measured in each time period, and the measured data were compared and analyzed. 2. According to the scanning data of 227 patients with cervical CT angiography performed from March 2012 to March 2013, the shape and variation of atlantoaxial joint of vertebral artery and the facial bone structure of inferior atlas joint were studied. The facial bone structure of superior articular axis was measured and analyzed. Results: 1. There was no significant difference in the relative signal intensity of T _ 1WI ~ T _ 2WI between the preoperative spinal cord area and the postoperative time. 2. Vertebral arteries often form four constant contiguous bends and four types of variation in the lateral atlantoaxial joint. The diameter of the lateral atlantoaxial joint, the width and height of the posterior arch at the bottom of the sulcus of the vertebral artery, the external inclination angle of the superior articular surface of the axis, the external inclination angle of the transverse foramen and the indentation of the vertebral artery were all significantly different (P 0.05). Conclusion: 1. Ligation of the venous plexus of the lateral atlantoaxial joint did not affect the blood supply of the upper edge of the atlas to the lower edge of the axis and would not cause spinal cord injury. 2. The observation and measurement of atlantoaxial lateral joint structure by CT and 3D reconstruction of cervical vessels can provide theoretical basis for atlantoaxial lateral articular release reduction and internal fixation fusion through the posterior cervical approach.
【学位授予单位】：青岛大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R687.4;R445.2

【参考文献】