被迫体位患者的改良髋关节轴位X线投照技术研究  

A Study of Modified Axial X-ray Projection Technique of the Hip Joint in Patients in Forced Positions

作　　者：赖国朝 王天云 谢晓桐 马立恒 Lai Guozhao;Wang Tianyun;Xie Xiaotong;Ma Liheng(The First Affiliated Hospital of Guangdong Pharmaceutical University,Guangzhou 510000,Guangdong Province,China)

机构地区：[1]广东药科大学附属第一医院,广东广州510000

出　　处：《中外医药研究》2023年第7期138-140,共3页JOURNAL OF CHINESE AND FOREIGN MEDICINE AND PHARMACY RESEARCH

摘　　要：目的:利用螺旋CT容积再现技术(VR)虚拟仿真探索更适用于被迫体位患者的髋关节轴位X线投照技术。方法:随机选取2019年1—12月广东药科大学附属第一医院30例患者的骨盆CT、重建骨盆VR图。在CT后处理工作站上通过VR得到骨盆VR图。将VR图侧倾斜35°~65°,并向头侧倾斜40°~60°,筛选出15个模拟髋关节轴位X线投照体位。由2名具有丰富影像诊断经验的放射科医师分别采用盲法对15个模拟髋关节轴位X线投照体位的VR图效果进行评价,分析判断上述15个图像的优异度,得出被迫体位患者最佳的髋关节轴位X线投照方案为侧倾斜40°~60°,同时头侧倾斜60°,其中侧倾45°~55°,头侧倾斜60°的髋关节轴位观最符合髋关节轴位的X线投照标准。将此方案应用于2020年1月—2021年12月于广东药科大学附属第一医院收治的髋关节不适或临床怀疑股骨颈骨折患者150例,分析图像质量,判断图像优异率。结果:150例患者通过VR图模拟探索的被迫体位患者髋关节最佳轴位X线投照方案,得到优质图像129例,图像优异率达86%。结论:改良的髋关节轴位X线投照技术非常适用于被迫体位患者的髋关节轴位X线投照,操作简单,患者痛苦小,值得应用并予以推广。Objective:To explore a more applicable hip axial X-ray projection technique for patients in forced position using spiral CT volumetric reproduction(VR)virtual simulation.Methods:Pelvic CT and reconstructed pelvic VR maps of thirty patients were randomly selected from January-December 2019 at the First Affiliated Hospital of Guangdong Pharmaceutical University.The pelvic VR map was obtained by VR on the CT post-processing workstation.The VR map was tilted sideways by 35°to 65°and to the cephalad side by 40°to 60°,and fifteen simulated hip axial X-ray projection positions were screened.Two radiologists with rich experience in diagnostic imaging evaluated the effect of the VR maps for each of the fifteen simulated hip-axis X-ray projection positions using a blinded method.The analysis judged the excellence of the above 15 images,and concluded that the optimal hip axis X-ray projection scheme for patients in the forced position was a lateral tilt of 40°to 60°,along with a cephalad tilt of 60°,with a lateral tilt of 45°to 55°and a cephalad tilt of 60°the most consistent with the criteria for X-ray projection of the hip axis position.This protocol was applied to one hundred and fifty patients with hip discomfort or clinically suspected femoral neck fracture admitted to the First Affiliated Hospital of Guangdong Pharmaceutical University from January 2020 to December 2021 to analyze the image quality and determine the image excellence rate.Results:The optimal axial radiographic projection scheme of the hip joint in patients in forced positions explored by VR map simulation in one hundred and fifty patients yielded high-quality images in one hundred and twenty-nine cases,with an image excellence rate of 86%.Conclusion:The improved technique of axial radiography of the hip joint is very suitable for axial radiography of the hip joint in patients in forced position,which is simple to operate and less painful for patients,and is worth applying and popularizing.

关 键 词：被迫体位 髋关节轴位 X线投照技术 

分 类 号：R68[医药卫生—骨科学]