X线数字化断层融合成像在创伤性骨关节病变中的临床应用

陈刘成; 高许斌; 王震寰; 沈龙山; 陈少男; 周牧野; 沈俊杰

doi:10.13898/j.cnki.issn.1000-2200.2019.08.005

X线数字化断层融合成像在创伤性骨关节病变中的临床应用

Clinical value of X-ray digital tomosynthesis imaging in the diagnosis of traumatic osteoarthritis

摘要

摘要:
目的探讨X线数字化断层融合成像（digital tomosynthesis，DTS）在创伤性骨关节病变中的临床应用价值。
方法对44例创伤性骨关节病人行普通直接数字化X射线摄影系统（digital radiography，DR）摄影检查后，发现DR平片疑似骨折或骨折线显示欠清，以及骨折经内外固定术后图像显示欠佳者，均征得病人同意后再进行DTS成像检查，获得扫描范围内连续断层图像。对比分析DTS与常规DR图像质量，评价DTS临床应用价值。
结果DTS重建图像均能清晰显示骨关节结构，去除骨内外固定伪影，新鲜性骨折均能清晰显示骨折线；陈旧性骨折显示骨痂形成、断端愈合情况清楚，显示隐匿性骨折5例，排除骨折7例。
结论DTS在创伤性骨关节病变检查中操作简便、易行，诊断准确率高、辐射剂量较低，在复杂结构部位的骨折以及经内外固定术后骨折的诊断与复查有着极其重要的价值，值得临床进一步推广使用。

Abstract:
ObjectiveTo investigate the clinical value of digital tomosynthesis(DTS) in the diagnosis of traumatic osteoarthritis.
MethodsThe results of digital radiography(DR) examination in 44 patients with traumatic osteoarthritis found that the suspected fracture or fracture line was not clear, and the image of internal and external fixation of fracture was not well.All cases were detected using DTS to obtain the consecutive tomographic images within the scanning range.The image quality between DTS and conventional DR was compared, and the clinical application value of DTS was evaluated.
ResultsThe reconstructed DTS images could display the bone and joint structure, the internal and external fixation artifacts could be removed, the fracture line in fresh fracture could be clearly showed, the callus formation in old fracture could be showed, the healing of broken end was clear.The occult fracture in 5 cases was found, and the fracture was excluded in 7 cases.
ConclusionsDTS is simple and easy to operate in the examination of traumatic osteoarthropathy, and has high diagnostic accuracy and low radiation dose.It has extremely important value in the diagnosis and review of complex structure fractures after internal and external fixation, and is worthy of further promotion.

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