舟月、月三角关节于腕关节前后位X线平片的投影

The projection of scapholunate and lunotriquetra interval in the wrist anteroposterior radiography

目的观察舟月、月三角关节于常规和摄影装置调控下腕关节前后正位X线平片投影间隙的清晰率。方法选取100张常规、161张摄影装置调控的腕关节前后正位X线片，统计舟月、月三角关节投影间隙的清晰率，以及两关节在同张平片投影间隙的清晰率。结果舟月、月三角关节于常规腕关节前后正位X线平片投影间隙清晰率各为50％，二者均清晰及均不清晰率分别为10％；摄影装置调控下腕关节前后正位X线平片舟月、月三角关节投影间隙清晰率分别是75．15％，36．02％，27．95％和16．77％。结论常规腕关节前后正位X线平片摄影，清晰显示舟月或月三角关节间隙的几率分别是50％，清晰显示两关节的几率只有10％．逊于影像学专著的描述；摄影装置调控投照体位，舟月关节投影清晰率提高，月三角关节投影清晰率降低，表明它有稳定投照体位、提高其重复性的作用，但两关节于关节张平片投影的清晰率还是低于30％，难以满足临床需求。如何提高舟月、月三角关节平片投影清晰率，以及两关节的同显率，依然是摆在我们面前的问题之一。

Objective To observe scapholunate and lunotriquetra joint interval in the conventional wrist anteroposterior plain X-rays and the images using an apparatus to control the wrist position. Methods Selecting 100 normal conventional wrist anteroposterior plain images and 161 anteroposterior plain X-rays using an apparatus designed by Tian Guang-lei, and respectively to observe scapholunate and lunotriquetra interval, and to derive clarity rate. Results The clarity rate of scapholunate and lunotriquetra interval in the wrist conventional A-P view were 50%, both clear and not clear were 10% , respectively. The results in the projection using the apparatus to control the wrist position were 75.15%, 36.02%, 27.95% and 16.77%, respectively. Conclusion In the conventional wrist A-P view, the rate of clearly showing the scapholunate and lunotriquetra interval and the both showing were all inferior to the imaging monograph. A consistent projection stabilizing wrist position can provide greater clarity of scapholunate interval than conventional anteroposterior X-rays, but the lunotriquetra interval clarity was inferior to former, which suggest essentiality to ensure the wrist position and reproducibility. The clarity rate of both intervals on one image was less than 30%, which was far from the clinical requirement. How can simultaneously observe two clear joint intervals needs further study.