Wenger Katharina J, Hattingen Elke, Porto Luciana
Institute of Neuroradiology, University Hospital Frankfurt, Goethe University, 60528 Frankfurt am Main, Germany.
Children (Basel). 2021 Apr 23;8(5):329. doi: 10.3390/children8050329.
Inflammatory nontraumatic atlantoaxial rotatory subluxation (AAS) in children is an often-missed diagnosis, especially in the early stages of disease. Abscess formation and spinal cord compression are serious risks that call for immediate surgical attention. Neither radiographs nor non-enhanced computed tomography (CT) images sufficiently indicate inflammatory processes. Magnetic resonance imaging (MRI) allows a thorough evaluation of paraspinal soft tissues, joints, and ligaments. In addition, it can show evidence of vertebral distraction and spinal cord compression. After conducting a scoping review of the literature, along with scientific and practical considerations, we outlined a standardized pediatric MRI protocol for suspected inflammatory nontraumatic AAS. We recommend contrast-enhanced MRI as the primary diagnostic imaging modality in children with signs of torticollis in combination with nasopharyngeal inflammatory or ear nose and throat (ENT) surgical history.
儿童炎性非创伤性寰枢椎旋转半脱位（AAS）常常漏诊，尤其是在疾病早期。脓肿形成和脊髓受压是严重风险，需要立即进行手术治疗。X线片和非增强计算机断层扫描（CT）图像均不能充分显示炎症过程。磁共振成像（MRI）可全面评估椎旁软组织、关节和韧带。此外，它还能显示椎体分离和脊髓受压的迹象。在对文献进行范围综述并结合科学和实际考虑后，我们制定了针对疑似炎性非创伤性AAS的标准化儿科MRI检查方案。对于有斜颈体征且伴有鼻咽部炎症或耳鼻喉（ENT）手术史的儿童，我们建议将增强MRI作为主要的诊断成像方式。
