正常腕关节后前位与前后位X线片的影像学指标对比

Posteroanterior view versus anteroposterior view in morphological parameters for wrist

目的分析腕关节形态学参数在X线前后位片和后前位片上的差异性。方法采用标准X线摄片技术拍摄2020年7月招募的30例健康志愿者右腕关节的前后位和后前位片,分别测量桡骨远端最大宽度、桡骨远端最小宽度、乙状切迹宽度、桡骨茎突高度、尺偏角、舟月关节间隙、尺骨变异、腕骨角、下尺桡关节间隙、尺骨茎突指数在前后位片和后前位片的数值。结果通过X线后前位片和前后位片对比发现,志愿者右腕关节的桡骨远端最小宽度、桡骨远端最大宽度、乙状切迹宽度、尺偏角、桡骨茎突高度等测值差异无统计学意义(P>0.05);而舟月关节间隙、下尺桡关节间隙、腕骨角测值后前位片小于前后位片,尺骨变异、尺骨茎突指数测值后前位片大于前后位片,差异有统计学意义(P<0.01);常规后前位片对舟月关节(36.67%vs 83.33%,χ~2=13.611,P<0.01)和下尺桡关节(33.33%vs 73.33%,χ~2=9.643,P<0.01)的显影率低于前后位片。结论正常腕关节在X线后前位和前后位的一些测量指标具有差异,了解这些差异对腕部急诊损伤选择合适的拍片体位及腕部骨与韧带损伤的诊断、治疗有重要意义。

Objective To analyze the differences in wrist morphological parameters between anteroposterior(AP)and posteroanterior(PA)radiographs.Methods AP and PA radiographs of right hand-wrist joints of 30 healthy volunteers recruited in July 2020 were taken by standard X-ray technique.The maximum width of distal radius,minimum width of distal radius,width of sigmoid notch,height of radial styloid process,ulnar deviation angle,scapholunar joint space,ulnar variation,carpal angle,lower radioulnar joint space and ulnar styloid process index were measured on AP and PA radiographs respectively.Results There were no significant differences in the minimum width of distal radius,the maximum width of distal radius,the width of the sigmoid notch,the ulnar deviation angle and the height of radial styloid process between AP radiographs and PA radiographs(P>0.05).However,the scapholunar joint space and carpal angle in PA were statistically less than those in AP,ulnar variation and ulnar styloid process index were significantly greater than those in AP(P<0.01).The displaying rate of scapholunar space(36.67%vs 83.33%,χ2=13.611,P<0.01)and lower radioulnar joint(33.33%vs 73.33%,χ2=9.643,P<0.01)in PA were sigificantly lower than those in AP.Conclusion The significant differences in some measurement indexes of normal wrist between AP and PA X-ray pictures can be used to guide the diagnosis and treatment of wrist bone and ligament injuries in the emergency.