三种跟骨骨折影像检查方法的临床应用比较  

Three imaging methods for diagnosis of calcaneal fractures

作　　者：黄智[1] 王博[1] 刘璋[1] 林成业[1] 陆志锋[1] 王潇[1] 

机构地区：[1]广州开发区医院放射科,广州510730

出　　处：《中国骨与关节外科》2014年第6期519-522,共4页Chinese Journal of Bone and Joint Surgery

摘　　要：背景:多层螺旋CT的广泛应用使受检者接受X线辐射剂量日益增多。如何优化CT扫描参数以减少受检者的X线吸收剂量是目前研究的热点。目的:通过比较跟骨骨折3种影像学检查表现,探讨DSA Innova 3D在跟骨骨折中的诊断价值。方法方法:回顾性分析本院收治经手术证实的20例跟骨骨折病例资料,以手术所见为金标准,由2名有经验的影像诊断医师以双盲法对DSA、螺旋CT及CR骨折表现及图像的噪声值、剂量指数等进行评分,对比分析20例跟骨骨折DSA、螺旋CT及CR表现、受检者接受的X线辐射剂量、体位要求高低及检查时间长短比较。结果:跟骨骨折部位、类型、关节面塌陷程度及骨折片移位情况显示如下:DSA下20例均能清晰显示;螺旋CT下18例清晰显示,2例不能清晰显示;CR下3例能清晰显示,17例未见显示。DSA、螺旋CT及CR的图像噪声值分别为16、20、30 d BA;受辐射剂量分别为0.023、4.6、0.046 m Gy。检查摆体时间:螺旋CT 220 s,CR 120s,DSA 20 s。检查时间:螺旋CT 12 s,DSA 0.8 s,CR 1 s。图像SNR:DSA 2.7,螺旋CT 3.71,CR4.0。结论:DSA Innova 3D图像比螺旋CT及CR更能清楚显示骨折部位、类型、严重度及移位情况,同时减少受检者接受X线辐射剂量及检查时间,体位要求低,图像质量好,值得推广。Background： Universal application of multislice CT has been increasing X-ray absorbed dose for subjects. Nowaday, how to reduce X-ray radiation dose is widely focused by researchers.Objective： To compare three imaging examination for calcaneal fractures, and to explore the efficacy of DSA Innova 3D in diagnosis of calcaneal fractures.Methods： A retrospective study was done in 20 patients with calcaneal fractures treated in our hospital. The findings in surgical treatment were thought as gold standard of diagnosis. Image noise value and dose index of DSA Innova 3D, spiral CT and CR were assessed by two experienced imaging doctors by double-blind method. X-ray radiation dose, body position requirements and checking time were compared between different imaging methods.Results： Calcaneal fracture position, type, joint surface collapse and fracture displacement were clear displayed in 20 cases by DSA Innova 3D, in 18 cases by spiral CT and in 3 cases by CR. Image noise value was 16, 20, 30 d BA, respectively in DSA Innova 3D, spiral CT and CR. Radiation dose of DSA Innova 3D, spiral CT and CR was 0.023, 4.6 and 0.046 m Gy.The duration of body position adjustment was 220, 120 and 20 s in DSA Innova 3D, spiral CT and CR, respectively. Testing time was 12, 0.8 and 1 s and image SNR was 2. 7 in DSA, 3.71 in spiral CT, and 4.0 in CR.Conclusions： As compared with spiral CT and CR, DSA Innova 3D images can more clearly present displacement, injured position, fracture classification and severity and reduce X-ray radiation dose, operating time and body position requirements.

关 键 词：跟骨骨折 影像学表现 

分 类 号：R683[医药卫生—骨科学] R816.8[医药卫生—外科学]