OBJECTIVE: Craniocervical distraction injury is a class of injuries that involve the skull base, the atlas, and the axis. Although these injuries often are overt imaging and clinical findings, the injury can be masked during unreliable physical examinations and difficult to identify during diagnostic imaging. The goal of this study was to identify on coronal and sagittal CT multiplanar reformations precise measurements and qualitative relations between anatomic landmarks that can help in establishing the diagnosis of craniocervical distraction injury. MATERIALS AND METHODS: We performed a retrospective review of the cases of 35 patients with craniocervical distraction injury admitted to our trauma center from 2000 to 2006. Two independent radiologists made several qualitative and quantitative anatomic assessments on reformatted CT images through the craniocervical junctions (skull base through C2) of the 35 patients and of 50 other patients sustaining blunt trauma who were discharged without findings of cervical spinal injury. Logistic regression, recursive partitioning, and multivariate analysis were performed in an attempt to find measurements that differentiated the groups. RESULTS: Among the patients with craniocervical distraction injury, statistically significant positive correlations were found in several measurements, including midline occiput-C1 spinolaminar distance (p=0.0016), midline C1-C2 spinolaminar distance (p<0.0001), basion-dens distance (p<0.0001), sum of condylar displacement (p=0.0002), and basion-posterior axial line distance (p<0.0001). CONCLUSION: Several quantitative parameters on sagittal and coronal multiplanar CT reformations can be used to differentiate patients with craniocervical distraction injury from patients without this injury.
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机译：目的：颅颈分散性损伤是一类涉及颅底，寰椎和轴的损伤。尽管这些损伤通常是明显的影像学表现和临床表现，但是在不可靠的体格检查中可以掩盖这种损伤，并且在诊断影像学中很难识别出这些损伤。这项研究的目的是在冠状位和矢状位CT多平面重建中确定解剖学界标之间的精确测量值和定性关系，以帮助建立对颅颈牵引力损伤的诊断。材料与方法：我们对2000年至2006年收治于我们创伤中心的35例颅脑牵张伤患者进行了回顾性研究。两名独立的放射科医生通过颅颈交界处（颅底）对重新格式化的CT图像进行了定性和定量解剖评估通过C2）的35例钝性创伤患者和其他50例出院无颈椎损伤的患者。进行逻辑回归，递归划分和多变量分析，以试图找到区分各组的度量。结果：在颅脑牵张损伤患者中，多项测量值在统计学上均具有显着正相关，包括中线枕骨-C1脊柱椎孔距离（p = 0.0016），中线C1-C2脊柱椎孔距离（p <0.0001），基底-dens距离（ p <0.0001），con突位移的总和（p = 0.0002）和后轴距（p <0.0001）。结论：矢状和冠状面多平面CT重建的几个定量参数可用于区分颅脑分散注意力损伤患者和无此损伤的患者。
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