数字断层融合摄影在腕舟骨骨折内固定术后评估中的应用价值  

Application value of digital tomosynthesis in the evaluation of scaphoid fracture after internal fixation

作　　者：王浩东 兰永树[1] 罗铧 戴贵东 WANG Hao-dong;LAN Yong-shu;LUO Hua(Department of Radiology,the Affiliated Hospital of Southwest Medical University,Sichuan 646000,China)

机构地区：[1]西南医科大学附属医院放射科,四川646000 [2]四川省骨科医院放射科,成都610041

出　　处：《放射学实践》2020年第12期1581-1584,共4页Radiologic Practice

摘　　要：目的:探讨数字断层融合摄影(DTS)在腕舟骨骨折内固定术后评估中的应用价值。方法:90例行腕舟骨骨折内固定术的患者分别在术后1周和2个月时行腕关节普通数字化X线摄影(DR)及DTS检查,其中25例行CT检查。由两位放射科医师采用5分法对三种检查方法获得的图像质量进行评价,并进行统计学分析。由临床医师对术后2个月复查的普通DR和DTS图像上骨折愈合情况进行分析和比较。结果:在术后1周时,DTS组的图像质量评分为(3.59±1.20)分,高于DR组的(2.70±1.19)分,差异具有统计学意义(P<0.05)。在术后2个月时,DTS组的图像质量评分为(3.98±1.01)分,高于DR组的(2.91±1.12)分,差异具有统计学意义(P<0.05)。行CT检查的25例中,图像质量评分为(2.08±0.86)分,低于DTS的图像质量评分[(3.88±1.09)]分,差异具有统计学意义(P<0.05)。在术后2个月时DTS图像上能清晰显示骨折愈合情况的患者比例为91.1%(82/90),显著高于普通DR的64.4%(58/90),两组间差异具有统计学意义(P<0.05)。结论:在腕舟骨骨折内固定术后复查中DTS能更清晰地显示术区骨质结构及骨折愈合情况,成像质量优于普通DR和CT,具有更佳的临床应用前景。Objective:To investigate the value of digital tomosynthesis(DTS)in the evaluation of scaphoid fracture after internal fixation.Methods:A total of 90 cases of scaphoid fracture patients who underwent fixation surgery were examined by digital radiography(DR)and DTS at 1 week and 2 months after surgery,25 cases among them were examined by computed tomography(CT)simulta-neously.The image quality obtained by the three examination methods was evaluated by two radiologists through 5-score system.DTS was compared with DR and CT respectively then statistical analysis was performed.The fracture healing rates in 2 months after surgery between ordinary DR and DTS were analyzed and compared by clinicians.Results:The image quality score of DTS was higher than that of DR[(3.59±1.20)vs.(2.70±1.19)]at the first week with significant difference(P<0.05).The image quality score of DTS was higher than that of DR[(3.98±1.01)vs.(2.91±1.12)]after 2 months with significant difference(P<0.05).Among the 25 cases undergone CT examination,the image quality score of DTS was higher than that of CT[(3.88±1.09)vs.(2.08±0.86)]after 2 months with significant difference(P<0.05).Fracture and/or bone callus were clearly shown in 91.1%patients(82/90)on DTS,which was significantly higher than that on DR(64.4%,58/90),the difference was statistically significant(P<0.05).Conclusion:With the lack of organizations overlap on DR and metal artifacts on CT in the review after internal fixation of scaphoid fractures,DTS can more clearly show bone structure and fracture healing of the operation area,which has obvious advantages and high clinical application prospect.

关 键 词：舟状骨骨折 内固定术 数字断层融合摄影 数字化摄影 体层摄影术 X线计算机 图像质量 

分 类 号：R814.41[医药卫生—影像医学与核医学] R814.41[医药卫生—放射医学]