![脊柱四肢影像图解:正常解剖·常见变异·常见病变](https://wfqqreader-1252317822.image.myqcloud.com/cover/318/43604318/b_43604318.jpg)
二、CT解剖
(一)横断面(图1-2-19~图1-2-21)
![](https://epubservercos.yuewen.com/81431C/22919026301392106/epubprivate/OEBPS/Images/P1-2-19_13149.jpg?sign=1738776438-17yXOcO7A3fs3H2fbjkGFaIg4ceFFtoF-0-3903c63ecaff5e9462ba34e2a1dd1909)
图1-2-19 颈5椎弓根层面(窗宽1 500HU,窗位400HU)
1. 颈5椎体;2. 横突前结节;3. 横突后结节;4. 横突孔;5. 椎动脉;6. 颈5下关节突;7. 颈5椎弓根;8. 颈5椎板;9. 颈5棘突;10. 脊髓。
![](https://epubservercos.yuewen.com/81431C/22919026301392106/epubprivate/OEBPS/Images/P1-2-20_13154.jpg?sign=1738776438-1UfTf4bYuoIjMZUphiAhrViqSnHniVHd-0-02caae916a377c8147c099809682dc51)
图1-2-20 颈5/6椎间孔层面(窗宽1 500HU,窗位400HU)
1. 颈5椎体;5. 椎动脉;6. 颈5下关节突;8. 颈5椎板;9. 颈5棘突;10. 脊髓;11. 颈6上关节突;12. 颈5/6椎间关节;13. 颈5/6椎间孔。
![](https://epubservercos.yuewen.com/81431C/22919026301392106/epubprivate/OEBPS/Images/P1-2-21_13157.jpg?sign=1738776438-QtPYdIICzX0F3YfpO9BBKalDkMakeGZO-0-a6c94a3ffde96e843c60eb23477cc7a9)
图1-2-21 颈5/6椎间盘层面(窗宽1 500HU,窗位400HU)
5. 椎动脉;6. 颈5下关节突;8. 颈5椎板;10. 脊髓;11. 颈6上关节突;12. 颈5/6椎间关节;13. 颈5/6椎间孔;14. 颈5/6椎间盘;15. 颈6钩突;16. 颈5/6钩椎关节。
(二)冠状面重组(图1-2-22)
![](https://epubservercos.yuewen.com/81431C/22919026301392106/epubprivate/OEBPS/Images/P1-2-22_13539.jpg?sign=1738776438-LCZvgSQhpyEWuCv6nH8jLRRkRNS7RPJB-0-f00c3aeabb3c00270f088b5633a4a1d8)
图1-2-22 颈椎冠状面MPR重组(窗宽1 500HU,窗位 400HU)
A. 钩锥层面;B. 椎小关节层面;C. 椎管层面
1. 颈3椎体;2. 颈3横突;3. 颈3/4钩椎关节;4. 颈3/4椎间孔;5. 颈5下关节突;6. 颈5/6椎间关节;7. 颈6上关节突;8. 颈髓;9. 颈4椎板。
(三)矢状面重组(图1-2-23)
![](https://epubservercos.yuewen.com/81431C/22919026301392106/epubprivate/OEBPS/Images/P1-2-23_13543.jpg?sign=1738776438-whSINZqDkBefHDcMY0yP1d8rK2bjnTIx-0-5729d390dc30223658023272a7a80114)
图1-2-23 颈椎矢状面MPR重组(窗宽1 500HU,窗位 400HU)
A. 椎体层面;B. 椎间孔层面;C. 椎小关节层面
1. 颈3椎体;2. 颈3横突;4. 颈3/4椎间孔;5. 颈5下关节突;7. 颈6上关节突;8. 颈髓。
(四)三维重组(图1-2-24)
![](https://epubservercos.yuewen.com/81431C/22919026301392106/epubprivate/OEBPS/Images/P1-2-24_13925.jpg?sign=1738776438-SNjr8KMZrXAgGWeQfp3g7Ijscwi0Wxf6-0-c1709b0b902a4f8e8c8a2371bca542ac)
图1-2-24 颈椎CT三维重组(VR)
A. 前面观;B. 右侧面观;C. 右后面观;D. 后面观1. 颈3椎体;2. 横突前结节;3. 横突后结节;4. 颈4/5钩椎关节;5. 颈3下关节突;6. 颈4上关节突;7. 胸1横突;8. 颈4椎板;9. 颈7棘突 ;10. 颈3/4椎间关节;11. 颈4/5椎间孔。
(五)病变展示(图1-2-25~图1-2-28)
![](https://epubservercos.yuewen.com/81431C/22919026301392106/epubprivate/OEBPS/Images/P1-2-25_13929.jpg?sign=1738776438-SHHyfbPu3oFbpM5tb51XnhfmjFewe2zZ-0-0c38e5e9a4d36f01b4e9da96335adcc4)
图1-2-25 颈椎融合(先天性阻滞椎)
A. 颈4/5融合,仍有退化残留的椎间盘,表现为椎间隙狭窄且伴有边缘硬化,注意椎体外形改变,矢状径减小,与椎间盘退变所致的椎间隙狭窄可资鉴别;B. 颈2/3完全融合,白箭所示为发育不良的寰椎后弓。
![](https://epubservercos.yuewen.com/81431C/22919026301392106/epubprivate/OEBPS/Images/P1-2-26_14309.jpg?sign=1738776438-hkJ724Resoz5vZLTe3LlfXIYkJP54X2h-0-4d0f0ecbf61ea7778ea62019860787bc)
图1-2-26 颈6椎体骨折及脱位
A. X线侧位;B. CT正中矢状面重组;C. CT椎小关节层面矢状面重组。颈椎侧位由于肩部软组织遮挡,下位颈椎显示不清,CT矢状面MPR显示颈椎序列不齐,颈5椎体前移,下位颈椎多发骨折,并见颈5/6椎小关节绞锁(白箭)。
![](https://epubservercos.yuewen.com/81431C/22919026301392106/epubprivate/OEBPS/Images/P1-2-27_14312.jpg?sign=1738776438-FnaZftuMhW1e4NmUOys4YAj48uY9NneT-0-32e04da8d9106fe9056d74f7516ea57e)
图1-2-27 颈3椎体前下缘撕脱骨折
A. 颈3椎体前下缘透亮线(箭);B. CT矢状MPR显示骨皮质中断,为撕脱骨折(箭)。需与永存骨骺、前纵韧带钙化鉴别。
![](https://epubservercos.yuewen.com/81431C/22919026301392106/epubprivate/OEBPS/Images/P1-2-28_14315.jpg?sign=1738776438-JOeLi6h0QzebJY8NyFwIdryyHkgLEWud-0-c648de40ff99e6c546ecd6e25822b31b)
图1-2-28 颈椎韧带钙化伴椎管狭窄
A. CT矢状面重组;B. 横断面。显示前纵韧带(箭)、后纵韧带(箭头)和项韧带(★)多发骨化,椎管矢径约6mm(<12mm),为椎管狭窄。颈4椎体前下缘前纵韧带骨化影需与撕脱骨折鉴别,前者边缘较致密。