数字化断层融合技术在隐蔽骨折诊断中应用价值

The applied value of digital tomosynthesis in diagnosis of occult bone fracture

目的了解隐蔽骨折诊断中数字化断层融合技术的应用价值。方法回顾性分析该院2012年3月—2014年9月收治的136例经平片检查呈阴性、无法排除隐蔽骨折或经X线证实为疑似骨折的患者的临床资料,均接受数字化断层融合图像及数字数字X线摄影检查,探究数字化断层融合技术对隐蔽骨折的诊断意义。结果 (1)图像良好率比较:136例患者中数字化断层融合图像良好94例,一般40例,差2例,良好率达69.12%;数字X线摄影图像良好67例,一般50例,差19例,良好率达49.26%;(2)检查及随访结果比较:62例接受数字X线摄影均呈阴性,数字化断层融合图像提示4例寰枢椎骨折,3例半脱位;10例腕部、手足骨折;21例四肢关节骨折;8例腰椎、胸椎、颈椎骨折;5例鼻骨骨折;7例骶尾骨骨折;4例胸骨、眼眶、肋骨、下颌骨骨折;数字X线摄影提示53例可疑骨折,数字化断层融合图像确诊35例骨折,18例排除骨折;数字化断层融合与数字X线摄影均确诊24例正常。随访发现,数字化断层融合诊断吻合临床诊断结果,确诊96例骨折。结论数字化断层融合技术在隐蔽骨折诊断工作中具有十分重要的应用价值,临床上应引起足够重视。

Objective To understand the applied value of digital tomosynthesis in diagnosis of occult bone fracture. Methods Both DR and DTS were performed in 136 cases which were treated at Taiyuan Central Hospital from March 2012 to September 2014. All the cases were suspected of bone fracture but with no abnormal findings in DR images. All the cases were reviewed and ana-lyzed to find the value of of digital tomosynthesis in diagnosis of occult bone fracture. Results （1） The comparison of good rate of image： 94 cases were showed well in DTS images and 42 cases were not showed well. The good rate of DTS images were 69.12%, while the good rate of DR images were 49.26%. （2）The comparison of diagnosis： Bone fractures or joint dislocations of 62 cases were shown in DTS images but not in DR images, including atlanto-axial fracture and subluxation in 7 cases, bone fractures of hand and foot in 10 cases, fracture of limbs in 21 cases, articular fractures of cervical, thoracic and lumbar vertebra in 8 cases, fracture of nanal bone in 5 cases,fracture of sacrococcyx in 7 cases, fractures of sternum, rib, mandible in 4 case. 53 cases with bone fracture were determined by using DTS in suspected cases and 18 cases were denied by DTS. Both DR and DTS images showed normal findings in 24 cases. 96 cases were diagnosed by DTS and it was consistent with the results of follow up. Conclu-sion DTS has great applied value in the diagnosis of bone fracture and should be paid enough attention in clinic.