腕关节尺偏旋后45°掌下斜位应用于舟状骨腰部骨折、移位的诊断效能分析  

Analysis of the diagnostic efficiency of wrist joint ulnar deviation supination 45°palmar oblique position for scaphoid waist fracture and displacement

作　　者：陈诗飞 张均[1] 韩舒曼 吴文娟[1] 钟志伟[1] 李静[1] 郭哲[1] 吴慧钊[1] 乔仔依 CHEN Shifei;ZHANG J un;HAN Shuman;WU Wenjuan;ZHONG Zhiwei;LI Jing;GUO Zhe;WU Huizhao;QIAO Ziyi(Department of Radiology,the Third Hospital of Hebei Medical University,Shijiazhuang 050031,China)

机构地区：[1]河北医科大学第三医院放射科,河北石家庄050031

出　　处：《实用放射学杂志》2024年第5期805-808,共4页Journal of Practical Radiology

基　　金：河北省卫生健康委员会跟踪项目(GZ2022036)。

摘　　要：目的探讨腕关节尺偏旋后45°掌下斜位对诊断舟状骨腰部骨折、移位的临床应用价值。方法分析93例腕关节外伤患者的数字化X线摄影(DR)、CT等影像学资料和临床资料,由3名阅片者对腕关节正位+侧位、舟状骨位、腕关节尺偏旋后45°掌下斜位、舟状骨位+腕关节尺偏旋后45°掌下斜位4种阅片方式进行分析,比较不同阅片者间的评价一致性以及各体位视图诊断舟状骨骨折、移位的敏感度、特异度等诊断效能。结果评估舟状骨腰部骨折及移位的观察者一致性及敏感度、特异度、准确率等诊断效能,腕关节尺偏旋后45°掌下斜位+舟状骨位、腕关节尺偏旋后45°掌下斜位均优于舟状骨位和腕关节正位+侧位。其中腕关节尺偏旋后45°掌下斜位+舟状骨位的组合获得最佳的诊断效能。结论腕关节尺偏旋后45°掌下斜位较好显示舟状骨长轴的斜位像,在诊断舟状骨腰部骨折及移位方面具有较高的诊断效能,可作为其他舟状骨影像的有益补充。Objective To investigate the clinical application value of wrist joint ulnar deviation supination 45°palmar oblique position in the diagnosis of scaphoid waist fracture and displacement.Methods The imaging and clinical data such as digital radiography(DR),CT of 93 wrist joint trauma patients were analyzed.The four position views including wrist joint anteroposterior+lateral view,scaphoid position,wrist joint ulnar deviation supination 45°palmar oblique position,scaphoid position+wrist joint ulnar deviation supination 45°palmar oblique position were analyzed by three readers.The consistency of the evaluation among different readers and the diagnostic efficiency of the diagnosis of scaphoid fracture and displacement were compared.Results The inter-observer agreement,sensitivity,specificity,accuracy,and other diagnostic efficiency of scaphoid waist fracture and displacement was evaluated,wrist joint ulnar deviation supination 45°palmar oblique position+scaphoid position and wrist joint ulnar deviation supination 45°palmar oblique position were better than those of scaphoid position and wrist joint anteroposterior+lateral view.The combination of wrist joint ulnar deviation supination 45°palmar oblique position+scaphoid position obtained the best diagnostic efficiency.Conclusion Thewrist joint ulnar deviation supination 45°palmar oblique position shows the long axis of the scaphoid,which has a high diagnostic efficiency in the diagnosis of scaphoid waist fracture and displacement and would be used as a useful supplement to other scaphoid imaging.

关 键 词：舟状骨 骨折 数字化X线摄影 

分 类 号：R683[医药卫生—骨科学] R814.41[医药卫生—外科学]