双能X线骨密度仪检查及数字化X线摄影术用于骨搬移术后  

Dual energy X-ray absorptiometry examination and digital radiography applicated after bone transport

作　　者：王凯君 谭新欢 谭桂萍 林明强 杨文江 WANG Kaijun;TAN Xinhuan;TAN Guiping;LIN Mingqiang;YANG Wenjiang(Department of Radiology,Shandong Wendeng Orthopaedic Hospital,Weihai 264400,China;Department of Bone and Hand Microsurgery,Shandong Wendeng Orthopaedic Hospital,Weihai 264400,China)

机构地区：[1]山东省文登整骨医院放射科,山东威海264400 [2]山东省文登整骨医院骨手显微外科,山东威海264400

出　　处：《中国医学影像技术》2022年第12期1857-1861,共5页Chinese Journal of Medical Imaging Technology

基　　金：山东省中医药科技项目(2021M062)。

摘　　要：目的观察骨搬移术后应用双能X线骨密度仪(DEXA)检查及数字化X线摄影术(DR)的价值。方法对19例因胫骨外伤致感染性骨不连及大面积骨缺损接受胫骨搬移术患者分别于术后2、4、6及8周、停止搬移即刻、停止搬移后4、8周、去外固定架前4周及去外固定架即刻行DEXA和DR检查,观察不同时间点胫骨搬移区新生骨痂(BMD新生骨痂)和截骨上下端原骨质骨密度(BMD截骨上下端)及二者比率,分析DR图像中胫骨新生骨痂的形态及填充量。结果胫骨搬移术术后各时间点BMD新生骨痂、BMD截骨上下端及BMD比率总体差异均有统计学意义(P均<0.05)。BMD新生骨痂及BMD比率在术后2周分别为(0.07±0.01)g/cm^(2)及(5.56±1.24)%,且均随术后时间延长而升高(P均<0.05);BMD截骨上下端在术后2周为(1.21±0.07)g/cm^(2),随时间延长而降低,去外固定架前4周降至最低(P均<0.05)、去外固定架即刻有所升高但与前者差异无统计学意义(P>0.05)。DR显示,术后4周胫骨搬移始区见新生骨痂影,随时间延长而呈多形态变化;术后2周胫骨搬移区未见新生骨痂填充,至停止搬移即刻新生骨痂填充量达25%,停止搬移4、8周达50%、75%,去外固定架前4周基本达100%。结论DEXA能动态监测骨搬移术后搬移区新生骨痂及截骨端原骨质BMD;DR可显示新生骨痂形态变化;骨搬移术后联合应用二者有助于评估预后。Objective To observe the value of dual energy X-ray absorptiometry(DEXA)examination and digital radiography(DR)applicated after bone transport.Methods DEXA and DR examinations were performed in 19 patients who underwent tibia transport with infected bone nonunion and large bone defect 2,4,6 and 8 weeks after operation,immediately after removal,4 and 8 weeks after removal,4 weeks before removal of external fixator and immediately after removal of external fixator.The bone mineral density(BMD)of the new callus in the tibia transport area(BMD_(new callus)),the upper and lower ends of the osteotomy(BMD_(lower and upper ends of osteotomy)),and ratio of the two BMD were measured and counted at different time points after operation.The morphology and filling volume of the new callus of the tibia on DR images were analyzed.Results There were significant differences of BMD_(new callus),BMD_(lower and upper ends of osteotomy)and BMD ratio among all time points after tibia bone transport(all P<0.05).BMD_(new callus)and BMD ratio 2 weeks after operation was(0.07±0.01)g/cm^(2)and(5.56±1.24)%,respectively,which increased with time going(all P<0.05).BMD_(lower and upper ends of osteotomy)2 weeks after operation was(1.21±0.07)g/cm^(2),which decreased to the lowest level 4 weeks before removal of external fixator with the extension of postoperative time(all P<0.05),but slightly increased immediately after removal of external fixator,but not significantly different with the former(P>0.05).DR showed that new callus shadow in tibia transport area was visible 4 weeks after operation,which changed visually with time going.No new callus filling in the tibia transport area was detected 2 weeks after operation,while the filling volume reached 25%immediately after removal,reached 50%and 75%at 4 and 8 weeks after removal and almost 100%at 4 weeks before removal of external fixator.Conclusion DEXA could dynamically monitor BMD of new callus and osteotomy end,and DR could show the morphological changes of new callus.Combining of DEXA and

关 键 词：骨折 骨 骨密度 骨痂 X线透视检查 骨搬移术 

分 类 号：R683.42[医药卫生—骨科学] R445.4[医药卫生—外科学]