DR和MSCT对下尺桡关节脱位定量评价的比较

The comparison of quantitative evaluation for distal radioulnar joint dislocation between digital radiography and MSCT

目的比较数字化X线摄片(DR)和多层螺旋CT(MSCT)对下尺桡关节(DRUJ)脱位定量评价的差异。方法选择74例均行DR和MSCT检查且DRUJ脱位的患者,由一位影像科副主任医师在PACS工作站上,借助DR片和MSCT后处理重建图像进行DRUJ脱位程度的测量,并进行统计学分析。结果 74例患者中Colles骨折46例,Galeazzi骨折3例,Smith骨折6例,前臂其他骨折12例,7例没有骨折。其中DRUJ横向、纵向和掌或背侧半脱位分别是31例、17例和26例,DR片上测量横向、纵向和掌背侧脱位或半脱位间距分别是(5.5±2.3)mm、(8.5±2.6)mm、(5.7±1.6)mm,MSCT测量分别是(7.1±2.5)mm、(9.3±1.8)mm、(3.4±1.2)mm,两种测量方式间比较,纵向脱位间距没有统计学差异(P>0.05),相关性为0.71,横向、掌或背侧脱位间距间存在统计学差异(P<0.05),相关性为0.65和0.52。结论 DR和MSCT对DRUJ脱位或半脱位定量评价是可行的,但DR测量受到多种因素的影响,准确性不如MSCT,尤其在评价掌背侧半脱位时。

Objective To compare the difference of quantitative evaluation for distal radioulnar joint（ DRUJ） dislocation between digital radiography（ DR） and multi-slice CT（ MSCT）. Methods A total of 74 DRUJ dislocation patients underwent both DR and MSCT examination were collected in this study. One associate chief physician in radiology department measured the degree of DRUJ dislocation on the DR images and MSCT processed reconstruction images on PACS workstation. The data were analyzed by statistics. Results For 74 patients,46 cases had Colles＇ fracture,3 Galeazzi fracture,6 smith fracture and 12 others＇ forearm fracture and 7 cases had no fracture. Among them,31 cases had DRUJ lateral dislocation,17 had longitudinal dislocation and 26 had volar or distal subluxation. And the lateral,longitudinal and volar or distal dislocation or subluxation distance were（ 5. 5 ± 2. 3） mm,（ 8. 5 ± 2. 6） mm,（ 5. 7 ± 1. 6） mm respectively on DR images and（ 7. 1 ± 2. 5） mm,（ 9. 3 ± 1. 8） mm,（ 3. 4 ± 1. 2） mm respectively on MSCT. There wasn＇t statistical difference for longitudinal dislocation distance and the correlation was 0. 71 between the two methods. Statistical differences were found for lateral,volar or distal dislocation distance and the correlations were 0. 65 and 0. 52 between the two methods. Conclusion It is feasible for quantitative evaluation of DRUJ dislocation or subluxation with DR and MSCT. However,DR is influenced by various factors and less accurated than MSCT,especially for the assessment of volar and distal subluxation.