拼接法全脊柱摄影外固定架的设计和自制

Design and development of a self-made external fixator for whole spinal photography through stitching

目的为部分有全脊柱摄影需求、但无该功能设备的医院介绍一种简易全脊柱摄影外固定架的自制,帮助其低成本实现全脊柱(长骨)摄影功能。方法采用不锈钢钢管、有机玻璃、玻纤板、报废X射线机的床面板等、带锁止的万向轮等,底座长宽各为60cm、高8cm的扁盒子,放填充物,提高稳定性。底座下面四个角安装带锁止万向轮。在底座上面四角上竖固定外径为40 mm的不锈钢管,高度约1.8 m,顶端焊成正方形,其中2根用于固定背板,另外2根为被检者上臂平前伸时手握。选择236例摄全脊柱片患者,其中男性158例,女性78例,年龄7～76岁。使用该固定架,进行数字X射线摄影(DR)。结果利用该外固定架,已摄影200余例,成像质量优于计算机X线摄影单次曝光拼接法。其中3例因患者年龄太大有少许左右移动错位外,其他全部合格,优秀率73%;曝光量设定错误,全片存在密度差异4例,但不影响诊断。结论对无全脊柱摄影功能的DR来说,只要有含拼接功能的工作站,利用自制外固定架,也能得到优质的全脊柱图像。

Objective To study a self-made whole spinal photograph external fixator for hospital without full spine photography equipment,and help them to realize the low-cost implementation of whole spine photography.Methods The flat box was made of stainless steel tube,organic glass,glass fiber board,discarded X-ray machine bed panel and universal wheel with lock.The base was 60 cm in width and length and 8 cm in height,with filler inside to improve stability.The bottom of 4 angles of the base were installed with universal wheels with lock,and a vertical stainless steel tube（40 mm in width and 1.8-meter in height） was fixed above each angle.The top was welded square,with 2 to fix the back and the other 2 for patients to grasp when stretched their arms.All of 236 patients（158 males and 78 females,aged 7-76 years old） were performed whole spine photography by digital radiography（DR） with fixator.Results The fixator was used for more than 200 cases with better image quality than that obtained by computed radiography exposure splicing.Among of them,3 cases had little dislocation movement because of aging,but all the others were qualified,with excellence rate reached 73 %.The exposure was mistakenly set and differences existed in the film density in 4 cases,but that did not affect diagnosis.Conclusion It is demonstrated that DR without full spine photography could get high quality of the whole spine using splicing function workstation with self-made external fixator.