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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。
Objective To investigate the imaging manifestations of atlantoaxial joint involvement in rheumatoid arthritis (RA). Methods The clinical manifestations of 16 patients with RA atherosclerotic atresia were analyzed retrospectively. The location, type, atlantoaxial joint involvement, the instability of atlantoaxial joint, dislocation and spinal cord oppression. Results The invasion sites of RA were mainly located in odontoid process, anterior arch and lateral mass. The incidence of central atlantoaxial joint and atlantoaxial joint was 56%, and atlantoaxial joint involvement was 25%. In 9 patients with atlantoaxial joint Dislocation, 4 cases with vertical dislocation and skull base depression; 11 cases of atlantoaxial synovial hyperplasia, 1 case with pseudotumor; 10 cases with C (1 ~ 2) level spinal cord compression and spinal cord degeneration; atlantoaxial dislocation and sliding The correlation coefficients of membrane proliferation and bone erosion were 0.2 and 0.4, respectively. Conclusions The RA is mainly involved in the cervical spine above the atlantoaxial spine. The involvement of the atlantoaxial joint and the atlantoaxial joint may lead to atlantoaxial dislocation, skull base depression and spinal cord compression.