直接数字化成像系统在成人骶尾部骨折中的诊断价值

Diagnostic value of Direct Digital Imaging System in adult sacroiliac fractures

目的探讨直接数字化成像系统在成人骶尾部骨折中的诊断价值。方法回顾性分析2010年1月至2011年12月50例骶尾部骨折患者,分两组分别行骶尾部正侧位X线片与DR片(X片组与DR组),两组均并行螺旋CT多平面重建确认,比较两组在确诊率、影像质量、后处理功能、患者等候时间与X线剂量的区别。结果 DR组患者的图像较X线组患者,图像分辨率高、清晰度大,且可进行对比增益、细节增强、图像切割、局部放大等处理,为医生的读片工作带来了极大的便利;DR组患者明确骨折、疑似、未发现者分别为18例(72%)、5例(20%)、2例(8%),X线组患者明确骨折、疑似、未发现者分别为8例(32%)、10例(40%)、7例(28%)。两组漏诊率比较,DR组患者为28%,X线组为68%,X线组高于DR组,差异有统计学意义(P<0.05);比较两组间患者等待时间、医生读片所用时间、洗片/成像所用时间、患者所受X线剂量,DR组患者分别为(6.1±0.9)min、(2.8±0.2)min、(14.2±0.5)s、(13.1±2.3)mGy,X线组分别为(25.3±5.4)min、(5.3±2.1)min、(276.2±52.1)s、(20.5±3.9)mGy,两组比较差异有统计学意义(P<0.05)。结论直接数字化成像系统的影像质量及对于成人骶尾部骨折的确诊率远远高于传统X线片技术,且具有辐射剂量少、等候时间短、后处理功能强大的优势,值得在临床上推广应用。

Objective To investigate the diagnostic value of Direct Digital Imaging System (DDIS) in adult sacroiliac fracture .Methods Front and lateral position sacroiliac X-rays and digital radiography (DR) detection were performed in 50 patients with sacroiliac fractures ,which were divided into X-rays group and DR group .Spiral compu-ted tomography (CT) multiplanar reformation spiral (MPR) was performed for confirmation .Definitely diagnostic rate ,image quality ,post-processing performance ,patients′waiting times and X-ray dose were compared between the two groups .Results The images of DR group were with higher resolution ratio and definition than those of X-ray group ,which could supply more convenience of the judgment of detection results .Numbers of patents with definite diagnosis ,suspected diagnosis and un-discovering in DR group were 18 cases (72% ) ,5 cases (20% ) and 2 cases (8% ) ,and those in X-ray group were 8 cases (32% ) ,10 cases (40% ) and 7 cases (28% ) .The misdiagnosis rate of DR group was 28% ,which was statistically different with the 68% of X-ray group (P<0 .05) .The waiting time of patients ,the doctors′reading time ,the washing/imaging time and the patient suffered X-ray dose were (6 .1 ± 0 .9) min ,(2 .8 ± 0 .2)min ,(14 .2 ± 0 .5)s and (13 .1 ± 2 .3)mGy in DR group ,which were statistically different with (25 .3±5 .4)min ,(5 .3 ± 2 .1)min ,(276 .2 ± 52 .1)s and (20 .5 ± 3 .9)mGy in X-ray group (P< 0 .05). Conclusion DDIS could be with higher image quality and diagnostic rate in adult sacroiliac fractures than convention-al X ray technology ,with advantages of less radiation dose ,less waiting time and powerful post-processing perform-ance ,which might be worth for clinical application .