[1]钟福华[],赵文俊[],段少银[].寰枢关节相关解剖变异及其影像学诊断[J].福建医药杂志,2017,39(3):26-29.
　ZHONG Fuhua[],ZHAO Wenjun[],DUAN Shaoyin[].Anatomic variation related to atlanto-axial joint and their imaging diagnosis[J].FUJIAN MEDICAL JOURNAL,2017,39(3):26-29.
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寰枢关节相关解剖变异及其影像学诊断
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《福建医药杂志》[ISSN:1002-2600/CN:35-1071/R]

卷:
39
期数:
2017年3期
页码:
26-29
栏目:
国外指南摘译
出版日期:
2017-06-15

文章信息/Info

Title:
Anatomic variation related to atlanto-axial joint and their imaging diagnosis
作者:
钟福华[1]; 赵文俊[2]; 段少银[3]
福建省龙岩监狱医院福建医科大学协和临床医学院福州350001厦门大学附属中山医院影像科
Author(s):
ZHONG Fuhua[1]; ZHAO Wenjun[2]; DUAN Shaoyin[3]
关键词:
寰枢关节; 解剖; 变异; 影像学诊断
Keywords:
atlanto-axial joint; anatomy; variation; imaging diagnosis
分类号:
R684R445
摘要:
目的统计患者影像学数据,显示寰枢关节相关解剖变异,明确变异的发生与表现,提高相关变异的影像学诊疗水平.方法1)利用我院影像归档和通讯系统(PACS)资料,查找2010年1月至2015年10月寰枢关节相关解剖变异病例共590例;2)分析寰枢关节相关解剖变异的影像学表现,进行解剖变异分型;3)利用三维重建技术,进行寰枢关节相关解剖变异的三维重建成像与分析;4)比较影像学检查方法.结果1)寰枢关节相关解剖变异590例,其中男性293例(49.66%),女性297例(50.34%),男女间差异无统计学意义.解剖变异包括4类:第1类,寰椎椎动脉沟环变异419例(71.02%);第2类,骨性融合或缺如113例(19.15%),其中寰枕融合10例,寰枢融合9例,C2-3融合84例,齿突变异5例,寰椎椎弓发育不全5例;第3类,椎动脉变异26例(4.41%),其中椎动脉走形异常5例,椎动脉发育异常4例,椎动脉纤细14例,椎动脉缺如3例;第4类,颅底畸形32例(5.42%),其中Chiari畸形20例,扁平颅底5例,颅底凹陷7例.2)影像检查与诊断:X线、CT、MRI分别发现第1类变异357例(60.51%)、93例(15.76%)、0例(0.00%);发现第2类变异4例(0.68%)、65例(11.02%)、15例(2.54%);第3类变异20例(3.39%)、6例(1.02%)、0例(0.00%);第4类变异17例(2.88%)、6例(1.02%)、24例(4.07%).接受2种以上影像学检查15例,其中结论不一致11例,均发生于第2类变异;三维重建技术诊断准确率达100%.结论寰枢关节相关解剖变异发现率为7.13%,男女无显著差别.第1类变异椎动脉沟环最多,都是经X线检查或CT诊断;第3类椎动脉变异由三维CT诊断最多;第4类Chiari畸形由MRI诊断最多.影像学检查诊断不一致均为第2类变异骨性融合或缺如,三维CT的应用有利于提高其诊断准确率.
Abstract:
Objective To show anatomic variation related to atlanto-axial joint in order to improve the level of clinical diagnosis and treatment on the anatomic variations by analyzing incidence of patients and application of imaging exam.Methods 1)A total of 590 patients with anatomic variation related to atlanto-axial joint were achieved from the PACS in our hospital from January 2010 to October 2015.2)Imaging and clinical manifestations of anatomic variation related to atlanto-axial joint were analyzed,as well as the type of variation on the characteristics of structural variation.3)3D imaging was used and anatomic variation related to atlanto-axial joint was analyzed.4)Imaging examination methods were compared.Results 1)All the 590 patients with anatomic variation related to atlanto-axial joint included 293 cases in male (49.66%) and 297 cases in female (50.34%),there was no statistical difference between male and female cases.Anatomic variations were divided into Type 1 of variation in 419 cases (71.02%);Type 2 of 113 cases(19.15%),including 10 cases of atlanto-occipital fusion,9 cases of atlanto-axial fusion,84 cases of C2-3 fusion,5 cases of odontoid variation and 5 cases of hypoplasia of posterior arch of atlas;Type 3 of anomalous vertebral artery in 26 cases (4.41%),including 5 cases of vertebral artery course variation,4 cases of developmental anomalies of the vertebral artery,14 cases of delicate vertebral artery,3 cases of vertebral artery absence;Type 4 of 32 cases (5.42%),including 20 cases of Chiari malformation,5 cases of platybasia and 7 cases of basilar invagination.2)Imaging examination and diagnosis:Type 1 variations discovered by X-ray,CT and MRI were 357 cases (60.51%),93 cases (15.76%)and 0 case (0.00%) respectively;type 2 variations discovered by X-ray,CT and MRI were 4 cases (0.68%),65 cases (11.02%),15 cases (2.54%) respectively;type 3 variations discovered by X-ray,CT and MRI were 20 cases (3.39%),6 cases (1.02%),0 case (0.00%)respectively;type 4 variations discovered by X-ray,CT and MRI were 17 cases (2.88%),6 cases (1.02%) and 24 cases (4.07%) respectively.Two or more imaging examinations were used in 15 patients,of which 11 cases were not consistent in their diagnosis,which occurred in the variation of type 2,then the accuracy rate of three-dimensional reconstruction was 100%.Conclusion Occurrence of anatomic variation related to atlanto-axial joint is 7.13%,it has no significant difference between the male and female.The most variations are the ponticulus posticus,which are diagnosed by the X-ray and CT or 3DCT.Anomalous of vertebral arteries is diagnosed by 3DCT and Chiari malformation by MRI.There are not consistent in diagnosing the variation of type 2 among the examination of X-ray,CT or 3DCT and MRI,of which 3DCT can improve its diagnosis accuracy.

备注/Memo

备注/Memo:
国家自然科学基金，厦门市科技计划项目
更新日期/Last Update: 1900-01-01