Gupta Vivek, Khandelwal Niranjan, Mathuria Suresh Narain, Singh Paramjit, Pathak Ashish, Suri Sudha
Department of Radiodiagnosis, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
J Comput Assist Tomogr. 2007 May-Jun;31(3):354-9. doi: 10.1097/01.rct.0000238009.57307.26.
To evaluate the role of dynamic magnetic resonance imaging (MRI) in craniovertebral junction (CVJ) abnormalities.
Twenty-five patients with suspected CVJ abnormalities underwent dynamic MRI of the CVJ, and in 20 of these patients, noncontrast computed tomography scan of the CVJ was done. The images were evaluated for atlantoaxial instability (AAI), spinal canal narrowing, cord compression, presence of altered cord signal intensity, and bony abnormalities in neutral, flexion, and extension.
Dynamic MRI detected 15 cases of AAI (10 fixed and 5 mobile AAI), 21 patients had varying degrees of spinal canal narrowing. Five patients showed increased narrowing on flexion/extension. Two patients demonstrated direct cord compression in flexion, whereas in neutral position, only dural compression was seen. One patient had cord compression on extension that was not seen in neutral or flexed position.
Dynamic MRI was able to detect cases of cord compression that were not seen in neutral position and was diagnostic in all cases of mobile AAI where mobility at this joint affects the treatment options. Dynamic MRI is extremely useful for evaluating craniovertebral junction abnormalities and, in particular, cord compression.
评估动态磁共振成像（MRI）在颅颈交界区（CVJ）异常中的作用。
25例疑似CVJ异常的患者接受了CVJ的动态MRI检查，其中20例患者还进行了CVJ的非增强计算机断层扫描。对中立位、屈曲位和伸展位的图像评估寰枢椎不稳（AAI）、椎管狭窄、脊髓受压、脊髓信号强度改变及骨质异常情况。
动态MRI检测出15例AAI（10例固定性和5例可动性AAI），21例患者存在不同程度的椎管狭窄。5例患者在屈伸位时狭窄加重。2例患者在屈曲位出现脊髓直接受压，而在中立位仅见硬膜受压。1例患者在伸展位出现脊髓受压，中立位和屈曲位未见。
动态MRI能够检测出中立位未见的脊髓受压情况，对所有可动性AAI病例具有诊断价值，该关节的活动度会影响治疗方案。动态MRI对评估颅颈交界区异常，尤其是脊髓受压极为有用。
