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寰枢椎脱位的影像学检查与分类:一篇叙述性综述

Imaging and classifications of atlantoaxial dislocation: a narrative review.

作者信息

Li Guangzhou, Zhang Hao, Wang Qing

出版信息

EFORT Open Rev. 2025 Jun 30;10(7):551-561. doi: 10.1530/EOR-2024-0061.

Abstract

Radiography is of importance in the diagnosis of atlantoaxial dislocation (AAD), and it is the basic imaging technique. However, it should not be the sole diagnostic modality, especially in complex or unclear cases. Conventional X-ray includes an open-mouth odontoid view and a cross-table lateral view, and careful study of radiological findings is crucial to give an early diagnosis of AAD. Lateral flexion-extension dynamic views are only used as an additional supplement in some special cases. Although X-ray images are enough to diagnose AAD in most cases, some patients suspected with AAD should be evaluated with the readily available and quick CT scan. If patients with AAD have symptoms of spinal cord and medullary compression, apart from conventional radiographs, a combination of high-quality CT and MRI of cervical spine are necessary for the diagnosis and choice of treatment. For patients with AAD, both the thin slice CT scanning with coronal, sagittal and three-dimensional reconstruction images and MRI of cervical spine are fundamental to surgical planning. Clinical classifications of AAD associated with imaging are useful in determining treatment strategies. The present study reviews publications on imaging and clinical classification of AAD to aid the clinician in the evaluation and management of these dislocations.

摘要

放射成像在寰枢椎脱位(AAD)的诊断中具有重要意义,是基本的成像技术。然而,它不应是唯一的诊断方式,尤其是在复杂或不明确的病例中。传统X线包括张口齿状突位片和水平侧位片,仔细研究影像学表现对于早期诊断AAD至关重要。侧屈-伸展动态位片仅在某些特殊情况下作为补充。虽然在大多数情况下X线图像足以诊断AAD,但一些疑似AAD的患者应进行便捷快速的CT扫描评估。如果AAD患者有脊髓和延髓受压症状,除了传统X线片外,高质量的颈椎CT和MRI联合检查对于诊断和治疗方案的选择是必要的。对于AAD患者,颈椎薄层CT扫描及冠状位、矢状位和三维重建图像以及MRI对于手术规划至关重要。与影像学相关的AAD临床分类有助于确定治疗策略。本研究回顾了关于AAD影像学和临床分类的文献,以帮助临床医生评估和处理这些脱位。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f4f9/12232392/2245daa8be48/EOR-2024-0061fig1.jpg

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