CT在减压性骨坏死诊断中的应用  

Application of CT scan in imageological diagnosis of dysbaric osteonecrosis

作　　者：肖吕武[1] 江朝强[1] 王兵[1] 于成福[1] 刘薇薇[1] 焦书海[1] 曹佰庆[2] 林春华 

机构地区：[1]广州市职业病防治院,广东广州510620 [2]交通部广州海上救助打捞局,广东广州510300 [3]交通部四航局广州市第一工程公司,广东广州510500

出　　处：《中国工业医学杂志》2007年第4期228-230,共3页Chinese Journal of Industrial Medicine

基　　金：卫生部"职业性减压病诊断标准修订研制"项目(编号:7-2000-039)

摘　　要：目的比较X射线和CT扫描在减压性骨坏死检查中的应用价值,探讨CT扫描在早期诊断减压性骨坏死中的意义,为修订新的职业性减压病诊断标准提供科学依据。方法选择66例潜水工龄一年以上的潜水员,分别进行双肩、双髋、双膝关节X射线和CT检查,分析这两种检查方法之间的符合率以及在不同部位对骨坏死的检出率。结果病损部位检出最多的是股骨上段,其他依次为肱骨上段、股骨下段、胫骨上段。X射线检出率为42.4%,CT的检出率为81.8%,X射线检查阳性后CT检查的诊断符合率为93.2%,CT的早期诊断率为68.4%。检出率X射线平片与CT相比,差异有统计学意义(P<0.001)。结论在减压性骨坏死的诊断中,CT扫描比X射线平片的检出率高,有早期诊断价值。Objective To compare the effect of roentgenography and CT scan in imageological diagnosis of dysbaric osteonecrosis （DON） and to research the value of CT scan in the early diagnosis of DON, thereby obtaining some scientific data for the revision of national diagnostic criteria for occupational decompression sickness. Method 66 divers with more than one year of diving experience were selected for the examination of both shoulders, hips and knees with X-ray and CT scan. Result Definite bone lesions were found by the examination, the most common places were upper femurs, then in sequence were upper humerus, inferior femurs, and upper tibias. The isolating rate of X-ray and CT were 42.4% and 81.8% respectively; the diagnosis accordance rates of CT scan in those who showed some abnormalities in hone by X-ray examination was 93.2% ; the early diagnostic rate of CT were 68.4%, which was much higher than that of X-ray examination （ P 〈 0.001）. Conclusion CT scan has higher isolating rate than that of X-ray examination and better value in the early diagnosis of DON.

关 键 词：减压性骨坏死 诊断 X射线检查 CT扫描 

分 类 号：R845.26[医药卫生—航空、航天与航海医学]