急诊放射学检查在骨盆损伤诊断中的作用

The effect of emergency radioscopy in the diagnosis of pelvic injuries

目的比较X线和CT诊断骨盆损伤部位和稳定性的敏感度。方法所有59例骨盆损伤病人均进行回顾性研究,均有骨盆前后位X线平片且至少行一种CT检查,随机任选一名不知道病情的骨科医生进行评估分析,然后由另一组独立医师对所有影像结合临床再次综合分析,得出病人骨盆损伤伤情和稳定性的正确结论,将两次结果进行比较性研究。结果前后位平片对所有骨盆损伤的诊断率是66%,其中前环是78%,而创伤CT的诊断率是86%,后环是93%。对骨盆损伤稳定性的敏感度,前后位平片是74%,出入口位是75%,创伤CT是93%,骨盆CT是100%。结论骨盆前后位X线平片联合创伤CT检查对骨盆损伤部位和稳定性的判断具有较高敏感性。

Objective To determine the sensitivity of roentgenograms and computed tomographic （CT） scans for pelvic pathology and instability Methods 59 patients with pelvic injuries were randomly reviewed by a orthopedic surgeon blinded to the study. Every patients had a minimum of two pelvic imaging studies, at least one plain film ,and one type of CT scan. Normal control roentgenograms and CT scans were included to decrease observer bias. Results The anteroposterior （AP） roentgenograms detected 66% of all pelvic injuries, 78% of these involving anterior ring. The trauma CT（TCT）, 10mm axial images of abdomen and pelvic, detected 86% of all pelvic injuries, including 93% of posterior ring injuries. The sensitivity for detecting pelvic instability from one plain film was 74%. Inlet and outlet views were 75%. Tlunma CT were 93% and high-definition CT scans （HDCT, 5mm peivie cuts） yielded 100% sensitivity. Conclusion A good quality AP pelvic roentgenograms in conjuction with the trauma CT can identify pelvic pathology and instability With a high degree of sensitivity.