数字化断层融合技术在尺骨冠状突骨折诊断中的应用评价

Application value of digital tomosynthesis in diagnosis of coronoid process of ulna fracture

目的探讨数字化断层融合技术(digital tomosynthesis,DTS)在尺骨冠状突骨折诊断中的临床应用价值。方法选取32例肘关节外伤患者,临床体征明显且DR检查阴性或可疑骨折,经患者同意,行DTS检查,对比DR检查与DTS检查结果,分析DTS检查在确诊尺骨冠状突骨折中的应用优势。结果对32例患者常规DR与DTS图像质量评分对比分析,差异有统计学意义(P<0.01)。32例患者中,DR检查可疑尺骨冠状突骨折14例,余18例患者未发现骨折;DTS检查确诊21例为尺骨冠状突隐匿骨折,排除骨折11例。经临床随访或CT进一步检查证实尺骨冠状突骨折22例。DTS检查敏感性及特异性均高于DR。结论 DTS图像能更好的显示肘关节的骨质结构,大幅度提高尺骨冠状突隐匿骨折的诊断正确率,可作为DR检查的有效补充和替代,具有重要的临床应用价值。

Objective To investigate the clinical application value of digital tomosynthesis（ DTS） in diagnosis of coronoid process of ulna fracture. Methods Thirty-two patients with elbow joint trauma whose clinical signs and DR detection were negative or suspicious fractures were enrolled in the study. These patients were examined by DTS,which was consented by patients themselves. The examination results by DR and DTS were analyzed and compared to evaluate the advantages of DTS in diagnosis of coronoid process of ulna fracture. Results There were significant differences in the image quality scores between DR and DTS（ P〈0. 01）. Among the 32 patients,DR detected 14 cases of suspicious coronoid process of ulna fracture,however,DTS detected 22 cases of definite coronoid process of ulna fracture,therefor,the sensitivity and specificity of DTS were superior to those of DR in diagnosis of coronoid process of ulna fracture. Conclusion DTS images can better display the bone structure of elbow joint and can greatly improve the diagnostic accuracy rate of occult fractures of coronoid process of ulna,which can be used as an effective supplement and substitute for DR detection,thus,which has important clinical application value.