探讨运用螺旋CT制定寰枢关节脱位的影像学诊断标准

发布时间：2018-02-15 03:11

  本文关键词： 寰枢关节 脱位 多参数 诊断 分型　出处：《重庆医科大学学报》2017年12期 　论文类型：期刊论文

【摘要】：目的:分析正常人群、寰枢关节脱位患者的薄层螺旋CT表现,筛选出最有效的诊断指标,制定寰枢关节脱位的影像学诊断标准。方法:收集颈椎正常人群(n=501)、寰枢关节脱位患者(n=51)的薄层螺旋CT资料,测量比较2组寰齿前间隙(anterior atlanto-dental interval,AADI)、寰齿后间隙(posterior atlanto-dental interval,PADI)、寰枢椎垂直脱位指数(vertical atlanto-axial index,VAAI)、寰枢侧方间隙(lateral mass interval,LMI)、寰枢椎相对旋转角度(rotating angle of atlas on dentata,RAAD)、齿突侧方间隙(lateral atlanto-dental interval,LADI)、寰枢椎侧方距离差、寰枢关节侧方成角多个参数,统计各型寰枢关节脱位例数并进行统计学比较。结果:寰枢关节脱位组,AADI、LADI、侧方成角均大于颈椎正常组;PADI、VAAI、LMI均小于颈椎正常组,差异有统计学意义(均P0.01)。AADI(0.795)、PADI(0.825)、VAAI(0.821)、LADI(0.890)的ROC曲线下面积大,诊断价值高。若满足下列任意一项,高度提示寰枢关节脱位:AADI≥2.2 mm、PADI≤15.4 mm、VAAI≤0.65、LADI≥4.4 mm。寰枢关节脱位的类型中,前后脱位7例(13.7%),垂直脱位11例(21.6%),旋转脱位1例(2.0%),侧方横向平移脱位2例(3.9%),侧方成角脱位1例(2.0%),复合脱位29例(56.9%)。结论:AADI、PADI、VAAI、LADI为诊断寰枢关节脱位高有效性指标,根据测量结果对寰枢关节脱位分型,采取合理的方法进行治疗具有重要意义。
[Abstract]:Objective: to analyze the thin slice spiral CT findings of patients with atlantoaxial dislocation and to screen the most effective diagnostic index. Methods: the imaging diagnostic criteria of atlantoaxial dislocation were established. Methods: thin slice spiral CT data were collected from patients with atlantoaxial dislocation of the atlantoaxial joint. The anterior atlanto-dental intervalation, posterior atlanto-dental intervalation, vertical atlanto-axial index and lateral mass intervalation were measured and compared in two groups. The relative rotation angle of atlantoaxial atlanto-axial was rotated angle of atlas on dentate RAADA, the lateral atlanto-dental intervalLADIA of odontoid process, the distance difference of lateral side of axis, and so on were measured and compared between the two groups. The cases of atlantoaxial joint dislocation were counted and compared statistically. Results: the lateral angle of atlantoaxial joint dislocation group was larger than that of normal cervical vertebrae group. The difference was statistically significant (P 0.01. AADI 0.795). The area under the ROC curve was large and the diagnostic value was high. If any of the following items were satisfied, the height indicated that the atlantoaxial dislocation of the atlantoaxial joint was less than 15.4 mm and VAAI 鈮，

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