普通与骨质疏松专长放射科医师的椎体骨折诊断率比较  

The comparison of vertebral fracture diagnosis rate between general radiologists and the radiologist specialized on osteoporosis

作　　者：颜丽笙[1] 蔡思清[1] 李毅中[2] 庄华烽[2] 蔡冬鹭[1] 何小波 

机构地区：[1]福建医科大学附属第二医院放射科,福建泉州362000 [2]福建医科大学附属第二医院骨科,福建泉州362000

出　　处：《中国骨质疏松杂志》2018年第2期187-191,共5页Chinese Journal of Osteoporosis

基　　金：福建省医药卫生科技创新项目(2015-CXB-18);泉州市科技项目(2014Z44)

摘　　要：目的比较普通与骨质疏松专长放射科医师X线胸部侧位像的椎体骨折诊断率。方法回顾性分析3216例50~95岁住院女患者胸部侧位像的椎体X线表现,将获得ISCD证书的放射科医师的评阅结果与既往普通放射科医师的报告结果进行比较分析,并比较不同年龄组的椎体骨折情况。结果 (1)既往普通放射科医师报告椎体脆性骨折98例,椎体骨折率为3.0%,报告中均未进行椎体骨折的分度诊断。获得ISCD证书的放射科医师诊断椎体脆性骨折数为374例576椎,椎体骨折率为11.6%,其中1个椎体骨折252例,2个椎体骨折81例,≥3个以上椎体骨折41例;576骨折椎中,轻度132椎(23.0%)、中度226椎(39.2%)、重度218椎(37.8%);获得ISCD证书的放射科医师诊断椎体脆性骨折显著高于普通放射科医师(P<0.01)。(2)50~59岁椎体骨折率为4.3%,60~69岁椎体骨折率为11.1%,70岁以上椎体骨折率为25.8%,各年龄组比较差异有统计学意义(P<0.01),在≥50岁女性中,椎体骨折率随着年龄的增加而增加。结论普通放射科医师诊断形态学椎体骨折漏诊率高,经过骨质疏松知识培训可以有效提高椎体骨折诊断率。Objective To compare the vertebral fracture identification rate on lateral chest radiographs between general radiologists and radiologist specialized on osteoporosis. Methods Lateral chest radiographies of 3216 hospitalized patients（ age range 50 to 95 years） were retrospectively reviewed for identification of vertebral fractures by ISCD-trained radiologist. The result made by ISCDtrained radiologist were compared with those made by general radiologists. Results 98 cases（ 3%） of fragile vertebral fracture were reported by general radiologists and the severity of vertebral fractures were not assessed. 576 vertebrae in 374 patients（ 11. 6%） were diagnosed with vertebral fracture by ISCD-trained radiologist,including 1 vertebral fracture in 252 cases,2 vertebral fractures in 81 cases,and 3 or more vertebral fractures in 41 cases. Of the 576 fractured vertebrae,mild grade fracture accounted for23%（ 132 vertebrae）,moderate grade fracture 39. 2%（ 226 vertebrae）,and severe grade fracture 37. 8%（ 218 vertebrae）. The rate of vertebral fracture diagnosis by ISCD-trained radiologist was higher than that by general radiologists（ P〈0. 01）. The rates of vertebral fracture in each age group respectively were 4. 3% in 50-59 years old,11. 1% in 60-69 years old,and 25. 8% in 70 years or older. There were statistically significant differences among all age groups（ P〈0. 01）. The vertebral fracture rate increased with aging in females aged ≥50 yrs. Conclusion The missing diagnosis rate of vertebral fracture was high in general radiologists. The diagnosis of vertebral fracture can be effectively improved through training radiologists for osteoporosis knowledge.

关 键 词：椎体骨折 胸部侧位片 骨质疏松 放射科医师 

分 类 号：R445.4[医药卫生—影像医学与核医学] R683.2[医药卫生—诊断学]