Yamashita Y, Takahashi M, Sakamoto Y, Kojima R
Department of Radiology, Kumamoto University School of Medicine, Japan.
Acta Radiol. 1989 Mar-Apr;30(2):135-40.
Twenty-nine patients with atlantoaxial subluxation (18 with rheumatoid arthritis, 2 due to trauma, 4 with os odontoideum, and one each with polyarteritis nodosa, rheumatic fever. Klippel-Feil syndrome, achondroplasia, and cause unknown) were evaluated using a 0.22 tesla resistive MRI unit. Cord compression was classified into four grades according to the degree on magnetic resonance imaging. There were 7 patients with no thecal sac compression (grade 0). 10 with a minimal degree of subarachnoid space compression without cord compression (grade 1), 7 with mild cord compression (grade 2), and 5 with severe cord compression or cord atrophy (grade 3). Although the severity of myelopathy showed poor correlation with the atlantodental interval on conventional radiography, high correlation was observed between MR grading and the degree of myelopathy. The high signal intensity foci were observed in 7 of 12 patients with cord compression (grades 2 and 3) on T2 weighted images. Other frequently observed findings in rheumatoid arthritis included soft tissue masses of low to intermediate signal intensity in the paraodontoid space, erosions of the odontoid processes, and atlantoaxial impaction on T1 and T2 weighted images.
29例寰枢椎半脱位患者（18例类风湿关节炎，2例因外伤，4例齿状突发育异常，结节性多动脉炎、风湿热、Klippel-Feil综合征、软骨发育不全各1例，病因不明1例）接受了0.22特斯拉电阻式磁共振成像（MRI）设备检查。根据磁共振成像上的程度，脊髓压迫分为四级。7例患者无硬脊膜囊压迫（0级）。10例蛛网膜下腔轻度受压但无脊髓压迫（1级），7例轻度脊髓压迫（2级），5例严重脊髓压迫或脊髓萎缩（3级）。虽然传统X线片上脊髓病的严重程度与寰齿间距相关性较差，但MR分级与脊髓病程度之间观察到高度相关性。在12例脊髓压迫患者（2级和3级）中的7例T2加权像上观察到高信号强度病灶。类风湿关节炎中其他常见表现包括齿状突旁软组织肿块呈低至中等信号强度、齿状突侵蚀以及T1和T2加权像上的寰枢椎撞击。
