CAJ | 학술논문

目的：探讨C T及三维后处理技术在诊断类风湿性关节炎累及寰枢关节中的临床价值。方法分析15例临床类风湿性关节炎确诊病例的寰枢关节CT图像，并利用工作站分别进行多平面重建（M PR）和容积再现（VR）成像等进行CT图像的三维后处理，分析寰枢关节骨质、关节间隙、是否半脱位及方向等CT表现。结果类风湿性关节炎累及寰枢关节的主要CT表现为骨质稀疏（6／15），骨质破坏（9／15），关节间隙的变窄或增宽；半脱位7例，其中前半脱位3例，侧方半脱位2例，前后脱位伴侧方脱位2例；2例出现颅底凹陷伴神经病变和椎动脉供血不足，4例因寰枢关节前半脱位引起椎管狭窄，造成脊髓压迫。结论 CT及三维后处理技术在类风湿性关节炎累及寰枢关节的诊断中发挥着重要的临床作用。
목적：탐토C T급삼유후처리기술재진단류풍습성관절염루급환추관절중적림상개치。방법분석15례림상류풍습성관절염학진병례적환추관절CT도상，병이용공작참분별진행다평면중건（M PR）화용적재현（VR）성상등진행CT도상적삼유후처리，분석환추관절골질、관절간극、시부반탈위급방향등CT표현。결과류풍습성관절염루급환추관절적주요CT표현위골질희소（6／15），골질파배（9／15），관절간극적변착혹증관；반탈위7례，기중전반탈위3례，측방반탈위2례，전후탈위반측방탈위2례；2례출현로저요함반신경병변화추동맥공혈불족，4례인환추관절전반탈위인기추관협착，조성척수압박。결론 CT급삼유후처리기술재류풍습성관절염루급환추관절적진단중발휘착중요적림상작용。
Objective To assess the CT findings of atlanto‐axial joint lesions in patients with RA using axial and three dimensional reconstruced computed tomography (CT) images .Methods Fifteen patients with Atlanto‐axial joint lesions due to RA who had undergone CT examination were included in our study .Multi‐planar reconstruction (MPR) and volume rendering (VR) CT images were reconstructed to investigate with precision the morphology of destruction of the odontoid process ,including bone and joint space lesions ,whether there were subluxation and dislocation direction .Results Atlan‐to‐axial joint lesions was due to RA ,CT characteristic included osteoporosis (6/15) ,destruction of bone (9/15) ,atlanto‐axial joint space narrowing or widening .7 cases of subluxation included anterior (3/15) ,lateral (2/15) and three directons (2/15) atlanto‐axial subluxation were analyzed .2 cases had basilar invagination with neuropathy and vertebral artery in‐sufficiency .4 cases with anterior atlantoaxial joint subluxation had spinal stenosis ,causing myelosuppression .Conclusion Axial and three dimensional reconstruced CT imaging is an important technique in the diagnosis of atlanto‐axial joint le‐sions in patients with RA .