Investigation on the use CT to make diagnostic radiographic criteria for atlanto-axial dislocation

Liu Zunhan; Huang Wei; Wu Xiangdong

doi:10.13406/j.cnki.cyxb.001432

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Investigation on the use CT to make diagnostic radiographic criteria for atlanto-axial dislocation

更新时间：2024-01-17

- Investigation on the use CT to make diagnostic radiographic criteria for atlanto-axial dislocation
- Journal of Chongqing Medical University Vol. 42, Issue 12, Pages: 1653-1657(2017)
- 作者机构：
  
  1. 重庆医科大学第一临床学院
  2. 重庆医科大学附属第一医院骨科
- 作者简介：
- 基金信息：
- DOI：10.13406/j.cnki.cyxb.001432
  CLC： R684;R816.8
- Published：2017，
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Liu Zunhan, Huang Wei, Wu Xiangdong. Investigation on the use CT to make diagnostic radiographic criteria for atlanto-axial dislocation. [J]. Journal of Chongqing Medical University 42(12):1653-1657(2017)
DOI：

Liu Zunhan, Huang Wei, Wu Xiangdong. Investigation on the use CT to make diagnostic radiographic criteria for atlanto-axial dislocation. [J]. Journal of Chongqing Medical University 42(12):1653-1657(2017) DOI： 10.13406/j.cnki.cyxb.001432.

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P<0.01)。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

Objectives:To investigate the differences of the CT images between normal people and patients with atlanto-axial dislocation

and to scree the most effective radiographic diagnostic indexes.Methods:The CT images of the normal people（n=501）and the atlanto-axial dislocation patients were collected.The anterior atlantodental interval（AADI）

posterior atlantodental interval（PADI）

vertical atlantoaxial index（VAAI）

lateral mass interval（LMI）

rotating angle of atlas on dentata（RAAD）

lateral atlanto-dental interval（LADI）

lateral mass overhang distance

atlanto-axial lateral mass rotating angle of two groups were measured.The various types of the altanto-axial joint dislocation were counted and the statistical analysis was made.Results:AADI

LADI

atlanto-axial lateral mass rotating angles were higher in atlanto-axial dislocation group than in normal group.PADI

VAAI

LMI were lower in atlanto-axial dislocation group than in normal group with significant differences（P<0.01）.The area under ROC curve of AADI（0.795）

PADI（0.825）

VAAI（0.821）

LADI（0.890） were high indicating high diagnostic value.If measured value met the following items

it prompted atlanto-axial dislocation:AADI≥2.2 mm

PADI≤15.4 mm

VAAI≤0.65

LADI≥4.4 mm.Conclusion:AADI

PADI

VAAI

LADI

atlanto-axial lateral mass rotating angles are the most effective diagnostic indexes of atlanto-axial dislocation.According the measured diagnostic results

it is important for a surgeon to chose the reasonable treatment.

关键词

寰枢关节脱位多参数诊断分型

Keywords

atlanto-axial jointdislocationmulti-parameterdiagnosistypes

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Related Institution

Department of Radiology，The First Affiliated Hospital of Chongqing Medical University

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Department of Traditional Chinese Medicine，Children’s Hospital，Zhejiang University School of Medicine/ National Clinical Research Center for Child Health

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