数字化X线摄影术组织均衡图像与CT图像在胸腰段椎体骨折诊断中的价值研究  

Study on Diagnosis of Thoracic and Lumbar Fractures with Digital Radiography Tissue Equalization and CT

作　　者：奚永强[1] 蔡庆斌[1] 李宏伟[1] 王丽[1] 

机构地区：[1]齐齐哈尔医学院附属第三医院放射科,黑龙江省齐齐哈尔市161000

出　　处：《中国全科医学》2012年第24期2838-2841,共4页Chinese General Practice

摘　　要：目的对比标准数字化X线摄影术(DR)图像、DR组织均衡处理图像及CT图像在胸腰段椎体骨折诊断中的价值。方法从本院2008年1月—2011年9月骨科手术证实胸腰段椎体骨折患者中随机抽取60例作为研究对象,均有外伤史。在医学影像存档与通讯系统(PACS)中,调取60例患者术前的影像学资料,包括DR胸腰段平片(正位、侧位及前斜位)、DR组织均衡处理后图像及CT胸腰段影像资料。分别对骨折检出情况、骨折部位、伴随症状进行对比分析,由4位有经验的诊断医生采用双盲法记录诊断结果。结果 (1)60例患者共有107处骨折,其中标准DR图像检出96处(89.7%),DR组织均衡处理图像检出105处(98.1%),CT图像检出101处(94.4%),3种方法检出率间差异有统计学意义(P<0.05);且DR组织均衡处理图像骨折检出率显著高于标准DR图像(P<0.01)。(2)在椎体骨折检出方面,标准DR图像、DR组织均衡处理图像及CT图像分别检查出45处(88.2%)、51处(100.0%)和46处(90.2%),差异有统计学意义(P<0.05);且DR组织均衡处理图像椎体骨折检出率显著高于标准DR图像及CT图像(P<0.05)。(3)在骨折碎片侵入椎管及神经受压方面,CT图像检出率显著高于DR组织均衡处理图像,差异有统计学意义(P<0.01)。结论在胸腰段椎体骨折诊断中,DR组织均衡处理图像优于CT,且DR组织均衡处理图像质量清晰,患者辐射剂量低,易于观察整体骨折特点;但在观察骨折碎片侵入椎管及椎管内神经受压方面,DR组织均衡图像的诊断结果不如CT。Objective To compare the diagnostic value of standard DR, tissue equalization （TE） and CT in thoraco- lumbar vertebral fractures. Methods 60 cases were randomly selected from among patients confirmed with thoracolumbar verte- bral fractures by orthopedic surgery from January 2008 to September 2011. All patients had trauma history, In the picture archiving and communication system （PACS）, preoperative images including DR thoracolumbar plain films （anteroposterior, lateral and former oblique）, DR TE images and thoracolumbar CT of the 60 patients were collected. The detection of fracture, fracture sites and accompanied symptoms were comparatively analyzed and the diagnosis results were recorded by four experienced doctors by u- sing double - blind method. Results （ 1 ） There were a total of 107 fractures in the 60 patients. Standard DR images detected 96 fractures （89. 7% ）, DR TE images detected 105 fractures （98.1%） and CT images detected 101 fractures （94. 4% ） . The difference of detection rate between the three methods showed statistically significant difference （ P 〈 0. 05 ） . The detection rate of DR TE images was significantly higher than standard DR images （P 〈0. O1 ） . （2） As for vertebral fractures, standard DR images, DR TE images and CT images detected 45 （88.2%）, 51 （ 100.0% ） and 46 （90.2%） fractures respectively, and the difference was statistically significant （ P 〈 0.05 ） . The detection rate of DR TE images on vertebral fractures was significantly higher than standard DR images and CT images （ P 〈 0.05 ） . （ 3 ） As for the fracture fragment invading the spinal canal and nerve compression, the detection rate of CT images was significantly higher than DR TE images （P 〈 0.01 ） . Conclusion DR TE images are superior to CT images in the diagnosis of thoracolumbar vertebral fractures with higher image quality, low patients radiation and easy observation of overall fracture characteristics. But as for the observation of fractur

关 键 词：骨折 数字X线摄影 体层摄影术 螺旋计算机 组织均衡 

分 类 号：R683.2[医药卫生—骨科学]