颈椎损伤的X线与CT诊断(1)
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【摘要】 目的 探讨常规X线和CT扫描对颈椎损伤的诊断价值。方法 对50例X线和CT诊断为颈椎损伤的病例进行分析。结果 本组50例,受损椎体共60个。低位颈椎骨折并(或)脱位27例,寰椎骨折9例,寰枢椎脱位8例,枢椎骨折6例。X线平片显示椎体后缘联线异常24例,CT片根据脊柱三柱结构诊断不稳定骨折28例,椎管0度狭窄22例,1度狭窄17例,2度狭窄8例,3度狭窄3例。外伤性颈椎间盘脱出10例。结论 对于颈椎损伤的患者,应常规行X线和CT扫描检查,以利于为临床提供更全面可靠的信息。CT能对颈椎损伤做出较全面、准确的诊断,有利于治疗方案的选择,可作为颈椎损伤临床术前诊断和治疗的影像学检查的首选方法。
【关键词】 颈椎损伤;X线平片;X线计算机体层摄影术
The Diagnosis of X-ray and CT for Cervical Spine Injury
HUANG Jing-long,ZHOU Peng,GAO Xue-mei.
Department of Radiology,Peoples Hospital of Zhongjiang District,Sichuan,Deyang 618100 China
【Abstract】 Objective To evaluate the diagnosis value of X-ray and CT for cervical spine injury.Methods The clinical data of 50 cases of vertebral spine injuries which were neglected due to missed diagnosis were analyzed retrospectively.Results 50 cases with cervical spine injury,among of them,27 cases with fracture and/(or) dislocation of the lower cervical vertebrae,9 cases had atlantal fracture,8 cases had atlantoaxial dislocation and 6 cases had the axoid fracture.24 cases showed abnormality in the lines of vertebral posterior border in the X-ray plain films.28 cases were diagnosed instabitity,22 cases vertebral canal 0°stricture,17 cases Ⅰ°stricture,8 cases Ⅱ°stricture,3 cases Ⅲ°stricture were diagnosed according CT films. 10 cases traumatic cervicales disc herniation.Conclusion X-ray and CT have their own localization for injured cervical vertebraes.We must perform X-ray and CT examination in order to provide overall and reliable information for clinical diagnosis. CT is becoming an indispensible and best modality of choices in the diagnosis of atloaxoid injuries helpful for the surgeon to decide clinical management.The advantages of CT are suggested that this diagnostic modality may be the standard method for the initial evaluation of the cervical spine injury.
【Key words】 Cervical Spine Injury; X-ray plain films; X-ray Computed Tomography
随着交通伤、坠落伤、暴力或运动伤日益增加,近年颈椎损伤日渐增多,但颈椎损伤的漏诊或延迟诊断率仍达5%～20%[1]。由于脊柱损伤是严重创伤,患者往往伴有其他脏器的损伤,如没有及时发现和采取必要的保护措施会造成严重后果,常造成患者高位截瘫,严重影响患者的生命及生活质量。本文回顾分析本院2008年11月至2009年10月资料完整的颈椎损伤50例影像学表现,报告如下,供参考。
1 资料与方法
1.1 一般资料 本组男性38例,女性12例。年龄4～60岁,平均40岁。受伤原因为车祸22例,摔伤13例,高处坠落10例,打击伤5例。临床表现上均有颈部疼痛,伴肢体不同程度感觉障碍。合并伤有头及颜面部、颈部皮肤损伤、四肢肿胀疼痛、颅脑损伤、腹部外伤、血气胸等。
1.2 检查方法 均为受伤后1～6 h内行X线平片及CT检查。X线平片检查采用岛津500 mA X线机或东软公司产500 mA X线机配AGFA-CR系统。全部病例均行常规X线平片正侧位检查,必要时加前后张口位片或左右双斜位片。根据X线平片所见颈椎明显骨折、脱位或可疑异常者即时行CT扫描检查 ......
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