CAJ | 학술논문

目的：通过对38例临床怀疑小儿寰枢关节半脱位X线影像资料的分析，结合文献资料，分析误诊的原因，预防的措施。方法：回顾性总结分析2010年3月至2014年4月前来我院就诊的15例和外院提供的23例临床怀疑寰枢关节脱位的患儿，将其分成两组。一组查体时临床症状不典型者有24例，另一组临床症状典型者有14例。两组患儿均摄颈椎侧位+张口位，测量及比较ADI、VBLADS及偏离齿状突距离，观察寰枢椎外侧关节面是否对齐例数。结果：两组ADI测量值及寰枢椎外侧关节面不对齐的例数有统计学差异（P<0.05），两组BVLADS值及偏离齿状突距离未见统计学差异。结论：准确测量ADI，观察寰枢椎外侧关节面是否错位是X线诊断小儿寰枢关节半脱位较可行的方法。齿状突与环椎两侧块间距离的差值（VBLADS）和寰底线中点垂线偏离齿状突轴线的距离做为诊断的参考指标。
목적：통과대38례림상부의소인환추관절반탈위X선영상자료적분석，결합문헌자료，분석오진적원인，예방적조시。방법：회고성총결분석2010년3월지2014년4월전래아원취진적15례화외원제공적23례림상부의환추관절탈위적환인，장기분성량조。일조사체시림상증상불전형자유24례，령일조림상증상전형자유14례。량조환인균섭경추측위+장구위，측량급비교ADI、VBLADS급편리치상돌거리，관찰환추추외측관절면시부대제례수。결과：량조ADI측량치급환추추외측관절면불대제적례수유통계학차이（P<0.05），량조BVLADS치급편리치상돌거리미견통계학차이。결론：준학측량ADI，관찰환추추외측관절면시부착위시X선진단소인환추관절반탈위교가행적방법。치상돌여배추량측괴간거리적차치（VBLADS）화환저선중점수선편리치상돌축선적거리주위진단적삼고지표。
Objective:With the help of literature, we discussed reasons for misdiagnosis and preventions by analyzing x-ray imaging of suspected atlantoaxial subluxation among 38 children. Methods:We reviewed all cases (15 cases from our hospital and 23 cases from others) of suspected atlantoaxial subluxation from Mar 2010 to Apr 2014 . 38 cases were divided into two groups based on clinical symptoms(24 cases were untypical clinical symptoms). They all were evaluated and compared ADI, VBLADS, the distance from odontoid in lateral radiograph of the temporal cervical vertebra and open-mouth , and observed the aligned number of lateral atlantoaxial articular surface. Results:ADI and ragged number of lateral atlantoaxial articular surface were statictically significant (P<0.05). BVLADS and the deflected distance from odontoid were no significant different . Conclusions: To measure ADI and observe lateral articular surface of atlantoaxial vertebral accurately are feasible methods to diagnose atlantoaxial subluxation in children. VBLADS and the distance from odontoid can be known as diagnostic criteria.