桡骨远端骨折CT扫描体位和成像方位的选择

The choice of the positions of the CT scan and imaging azimuth in the distal radius fracture

目的:探讨桡骨远端骨折后,CT扫描体位和成像方位的选择及临床意义。方法:58例患者中,20例按体位1扫描,即患者仰卧于检查床上患肢伸直而置于身体的一侧进行扫描,13例按体位2扫描,即患者仰卧或俯卧于检查床上患肢举过头顶进行扫描,17例按体位3扫描,即患者上半身横趴于检查床上,患肢置于扫描孔内扫描,8例按体位4扫描,即患者站立球管背侧患肢置于检查床上进行扫描。每个体位横断位扫描后,均通过弯曲肘关节进行矢状位和冠状位扫描。并根据检查时间长短,摆位难易,图像质量以及所受辐射量等,对不同扫描体位进行评价。结果:体位1扫描图像伪影多而影响图像质量,且受照辐射大。体位4摆位难,检查时间长,图像伪影多而总体评价最差。体位3图像伪影少,受照剂量低,易于进行多方位成像而有助于病变的显示和分型而评价最好。结论:桡骨远端CT可选择多种扫描体位,每种体位下通过伸直和弯曲肘关节可以进行横断位、冠状位和矢状位成像,选择合适的体位和成像方位有助于快速而有效完成检查,并准确诊断。

Objective： To investigate the evaluation and the clinical significance of the positions of the CT scan and imaging azimuth in the diagnosis of the distal radius fracture. Methods.. 20 of 58 patients who supined on the examination bed, with the affected limb of the patients stretched and placed on the side of the body, underwent the CT scans as position 1. 13 patients who supined or proned on the examination bed, with the affacted limb placed over their heads, were scanned as position 2. 17 patients whose upper body transversely groveled on the examination bed, with the affected limb placed in the scanning hole, were scanned as position 3. 8 patients who gtood in dorsal to the X-ray tube, with the affected limb placed on the examination bed, were scanned as position 4. Each of the positions was performed in CT axial scan, and then the patients underwent sagittal and coronal scans by bending the elbow. Different scanning positions were evaluated according to the length of examination time, the degree of difficulty of patient set-up, image quality, radiation dose and so on. Resuits： By the position 1, alot of image artifacts had an effect on the image quality, and the patients often sufferred lots of radiation. Position 4 had the worst overall assessment, because it was difficult to set up, wasting time and having lots of image artifacts. Position 3 was the best choice, which had fewer image artifacts and low radiation dose, and different positon which is useful for demonstration and the classification of the lesions is easy to set up. Conclusion： A variety of positions can be chosen in the CT scans of the distal radius fracture, and axial, coronal and sagittal imaging can be performed as each of positions by extending and bending elbow joint. Appropriate position and imaging azimuth can help quickly and effectively complete the examination and make the diagnosis more accurate.