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目的 探讨三维CT成像 ( 3DCT)对小儿寰枢椎旋转性移位 (atlanto axialrotatorydisplacement,AARD)的诊断价值。材料与方法 分析和比较 6例小儿AARD在普通CT扫描 ( 2DCT)和 3DCT中的影像表现。结果 ( 1) 2DCT和 3DCT测量 6例患儿寰齿前间距和齿状突侧距的结果基本相同 ;( 2 ) 3DCT显示 6例患儿侧块均有不同程度的移位和旋转 ,2DCT不能显示侧块有无移位和旋转 ;( 3) 6例中 ,2DCT显示 1例同时有寰椎 (C1)和枢椎 (C2 )的异常旋转 (分别为 8°和 35°) ,3例有C2 异常旋转 ( 7°～ 30° ,平均 18.7°) ,2例未发现寰枢椎的旋转异常。 3DCT显示 2例同时有C1和C2 旋转异常 (分别为 11°、30°和 11°、40°) ,4例有C2 旋转异常 ( 9°～ 34° ,平均 16 .5°)。相同病例 ,2DCT对C1和C2 旋转程度的测量低于 3DCT所测得的结果 ;( 4 ) 3DCT发现 1例齿状突发育不良 ,表现为齿状突短平和齿突尖消失 ,2DCT不能观察齿状突的发育状况。结论 3DCT对AARD的诊断作用明显优于 2DCT。 3DCT不仅能准确地、直观地评估齿状突和侧块的移位程度、方向以及寰枢椎的旋转程度 ,而且能发现伴发的寰枢椎尤其是齿状突发育畸形 ,对全面明确AARD诊断和指导治疗具有重要意义
Objective To investigate the diagnostic value of three-dimensional computed tomography (3DCT) in pediatric atlantoaxial rotational displacement (AARD). Materials and Methods Six cases of pediatric AARD were analyzed and compared for imaging findings in plain CT scan (2DCT) and 3DCT. Results (1) 2DCT and 3DCT measurements of 6 children with atlas and odontoid lateral distance of the results were basically the same; (2) 3DCT showed six cases of children with varying degrees of lateral displacement and rotation, 2DCT can not (3) In 6 cases, 2DCT showed abnormal rotation of atlas (C1) and axial (C2) in 1 case (8 ° and 35 °, respectively) and in 3 cases C2 abnormal rotation (7 ° ~ 30 °, mean 18.7 °), 2 cases did not find atlantoaxial rotation abnormalities. 3DCT showed two cases of C1 and C2 rotation abnormalities (11 °, 30 ° and 11 °, 40 °, respectively) and four cases had C2 rotation abnormalities (9 ° to 34 °, with an average of 16.5 °). In the same case, 2D CT measurements of C1 and C2 were lower than those of 3DCT. (4) One case of odontoid dysplasia was found by 3DCT. Odontoid developmental status. Conclusion The diagnosis of AARD by 3DCT is better than 2DCT. 3DCT can not only accurately and intuitively evaluate the degree of displacement and orientation of the odontoid and lateral mass, but also the degree of rotation of the atlantoaxial vertebra, and it can be found that the associated atlantoaxial spine, especially odontoid deformity, AARD diagnosis and guidance of treatment is of great significance