ＲＡ上位頚椎病変の画像診断

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  • Diagnostic imaging of upper cervical lesion in RA patients.

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The upper cervical spine (C1/C2) is often involved in the course of RA. Atlanto-axial subluxation and basilar impression secondary to the upper cervical involvement are the major problems. Recently some diagnostic imaging methods (i.e., computed tomography (CT), magnetic resonance imaging (MRI), etc.) have been offering more information about the anatomical change of the upper cervical region caused by RA. We report here on the clinical efficacy of CT and MRI in the diagnosis of upper cervical lesions of RA patients.<BR>CT reveals bone lesions clearly, and the functional analysis of C1/C2 during flexion, extension, and rotation of the cervical spine is useful. MRI offers good information about soft tissue changes including compression of the spinal cord, and when combined with Gadlinium-DTPA, defines the relationship of periodontoid pannus and bone more clearly. Postoperative MRI is also available for seeing the effects of surgery on spinal cord compression.

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