肘关节侧位改良摄影在显示桡骨头的实际应用  

Improvement of elbow joint lateral position for the display of radial head in actual application

作　　者：薛磊[1] 纪俊伟[1] 商旭[1] 曹锋[1] 陈雷[1] 綦维维[1] 

机构地区：[1]北京大学人民医院放射科,北京100044

出　　处：《实用放射学杂志》2015年第10期1661-1663,共3页Journal of Practical Radiology

摘　　要：目的：通过改良肘关节侧位 X 线摄影提高桡骨头病变的显示。方法对20例肘关节 CT 图像进行三维重组模拟 X 线摄影图像，测算 X 线摄影中肱骨与探测器的倾斜角度；20例肘关节 X 线摄影中加照改良肘关节侧位与常规肘关节侧位对比，并测量桡骨头关节面的无遮挡率。结果通过 CT 模拟肘关节图像得出实际 X 线摄影时肱骨与探测器的倾斜角度为30°~41°，平均（35.5±1）°。常规侧位桡骨头关节面遮挡率为71.6%~100%，无遮挡率0%~28.4%，平均14.2%，确诊骨折13例，疑似5例；改良侧位桡骨头关节面遮挡率为4.8%~25%，无遮挡率75%~95.2%，平均85.1%，确诊骨折17例，疑似1例。结论改良肘关节侧位比常规侧位更加直观地显示桡骨头及其病变情况。Objective To improve lesion detection of the radial head with adjusted elbow joint lateral position on X-ray.Methods （1）20 subjects underwent elbow joint CT three-dimensional reconstruction （average intensity projection）,which was as X-ray radio-graphy image.The tilt angle of the humerus and the projection direction for fully display of the radial head in projection images and the tilt angle of the humerus against detector in X-ray radiography were measured.（2）20 subjects （patients and volunteers）with el-bow joint disease underwent routine and improved elbow joint lateral position were enrolled.And assessed the bare blocking rate of the radial head articular surface of the two positions.Results （1）The angle between the the humerus and the direction of projection were 49°-60°and 30°-41°in CT and X-ray,respectively.The average angle was （35.5±1）°.（2）.The blocking rate and bare bloc-king rate of the radial head articular surface in routine elbow joint lateral position were 71.6%-100% and 0%-28.4%,respective-ly.The average rate of bare blocking was 14.2%.Fracture 13 cases and 5 cases of suspected fractures.The blocking rate and bare blocking rate of the radial head articular surface in improved elbow joint lateral position were 4.8%-25% and 75%-95.2%,re-spectively.The average rate of bare blocking was 85.1%.Fracture 1 7 cases and 1 case of suspectet fractures.Conclusion The im-proved elbow joint lateral position of X-ray can display the radial head articular surface better than the routine position.

关 键 词：改良肘关节侧位 桡骨头 遮挡率 

分 类 号：R816.8[医药卫生—放射医学] R681.7[医药卫生—临床医学]