The craniocervical junction: embryology, anatomy, biomechanics and imaging in blunt trauma.
The craniocervical junction: embryology, anatomy, biomechanics and imaging in blunt trauma.
复制标题
颅连接处：钝性创伤中的胚胎学，解剖学，生物力学和成像。
DOI：
10.1007/s13244-016-0530-5
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发表时间：
2017-02
影响因子：
4.7
通讯作者：
Day E
中科院分区：
文献类型：
--
作者：
Offiah CE;Day E
颅颈交界处钝性创伤的影像学检查具有挑战性，但对于改善与此类损伤相关的发病率和死亡率至关重要。放射科医生在适当处理颅骨和脊柱之间的重要连接处受伤的患者方面发挥着重要作用。胚胎学和正常解剖学以及正常变异外观的知识避免了这些创伤患者的不适当调查。骨损伤可能是轻微的，同时代表重要的潜在韧带损伤的重要放射学红旗。对骨和韧带损伤模式的理解也可以对造成这种创伤所需的生物力学和力量程度有所了解。这将大大有助于预测与重要邻近结构（如血管系统、脑干、颅神经和脊髓）相关的其他严重损伤的风险。本文将对颅颈交界处的胚胎学和解剖学进行概述，并对该部位钝性创伤可能导致的相关骨和韧带损伤进行描述。适当的二次放射成像的考虑有关的潜在并发症，这种创伤也将进行讨论。·颅颈交界处是一个独特的骨-韧带实体，具有特定的功能需求。了解颅颈交界处的胚胎学可以防止错误的放射学解释。·在钝性创伤中，韧带的解剖生物力学要求值得考虑。·专用MRI序列可以提供韧带完整性和损伤的准确评估。·颅颈交界处的损伤具有钝性创伤性脑血管损伤的风险。
Imaging of the blunt traumatic injuries to the craniocervical junction can be challenging but central to improving morbidity and mortality related to such injury. The radiologist has a significant part to play in the appropriate management of patients who have suffered injury to this vital junction between the cranium and the spine. Knowledge of the embryology and normal anatomy as well as normal variant appearances avoids inappropriate investigations in these trauma patients. Osseous injury can be subtle while representing important radiological red flags for significant underlying ligamentous injury. An understanding of bony and ligamentous injury patterns can also give some idea of the biomechanics and degree of force required to inflict such trauma. This will assist greatly in predicting risk for other critical injuries related to vital neighbouring structures such as vasculature, brain stem, cranial nerves and spinal cord. The embryology and anatomy of the craniocervical junction will be outlined in this review and the relevant osseous and ligamentous injuries which can arise as a result of blunt trauma to this site described together. Appropriate secondary radiological imaging considerations related to potential complications of such trauma will also be discussed. • The craniocervical junction is a distinct osseo-ligamentous entity with specific functional demands. • Understanding the embryology of the craniocervical junction may prevent erroneous radiological interpretation. • In blunt trauma, the anatomical biomechanical demands of the ligaments warrant consideration. • Dedicated MRI sequences can provide accurate evaluation of ligamentous integrity and injury. • Injury of the craniocervical junction carries risk of blunt traumatic cerebrovascular injury.