坐位髌骨轴位X线投照技术的临床应用

Clinical Application of Exposure Technique for Axial View Patella Radiography with Patient in Sedentary Position

目的:探讨坐位髌骨轴位X线摄影技术的临床应用及其实用意义。方法:取坐位投照髌骨,患者髋关节保持自然屈曲90°,屈膝角度范围30°～80°,然后调整中心线的入射角及入射点进行投照。结果:采用坐位髌骨轴位摄影者共138例,其中78例膝关节屈曲70°～80°,显示髌股关节完整,无重叠,关节间隙对称,评为“优”级片占5 7% ;5 5例膝关节屈曲5 0°～6 0°,显示髌股关节无重叠,关节间隙略不对称,评为“良”级片,占4 0 % ;两者均可获得满意的髌骨轴位影像,优良率达97%。另外5例屈膝关节为30°～4 0°,显示髌股关节重叠,关节间隙明显不对称,对诊断有影响,列为废片,占3%。结论:采用坐位髌骨轴位投照法,符合膝关节和髌骨之间的解剖特点及活动规律。其操作简便,患者舒适可配合摆位。屈膝关节4 0°～70°范围内均可获得髌骨轴位的良好影像,提高临床影像诊断准确率,临床实用性好,可以作为髌骨的常规检查。

Objective To introduce the clinical application and practicability of exposure technique for axial view patella radiography with Patient in sedentary position.Methods To take an axial view radiograph of patella with patient in sedentary position, the patients' hip joints were kept flexural with 90 degrees naturally and knees flexural between 30 to 80 degrees, then photos were taken by adjusting the angle and point of incidence of the central line.Results There are 138 cases were under investigation:78 cases with kneel flexure between 70 to 80 degrees showed the full patella-femur joint without overlapping, the joint interval is symmetrical,and 57 % of the radiographs were assessed as excellent.55 cases with knee flexure between 50 to 60 degrees showed patella-femur joint without overlapping,and the joint interval was a little dissymmetry, and 40 % of the radiographs were assessed as middling.Satisfying axial view patella was acquired on both of the two kinds of cases, with an eligible rate of 97 %.Overlapping patella-femur joint and joint interval of markedly dissymmetry was found in the remaining 5 caseses with the knee flexures between 30 to 40 degrees, the radiographs of which, occupying 5 % of the total amount, were treated as invalid for they had no value of diagnosis.Conclusion The exposure method for axial view patella radiography with Patient in sedentary position accords with the anatomic feature and movement mode of the knee joint and patella-femur joint;in addition,it is very easy to conduct and enables patients to pose themselves comfortably.The decent radiographs can be obtained with the knee flexion in the range between 40 to 70 degrees. It improves accuracy of clinical imaging diagnosis with good clinical practicability, so it can be used as a conventional examination for the patella.