放射学检查在颈椎损伤早期诊断价值的研究

评估传统放射学检查方法对颈椎损伤早期诊断价值。对１５２例疑有急性颈椎损伤的成人患者行常规放射学检查即颈椎侧位片、前后位片及枢椎齿状突开口位片检查，并与断层扫描、ＣＴ扫描及ＭＲＩ检查结果进行比较。结果１５２例患者中８７例发生颈椎骨折（占５７．２％）；颈椎侧位片诊断的敏感性、特异性和准确性分别是８４％、７４％和８０％，而颈椎常规放射学诊断的敏感性、特异性和准确性分别为９３％、８０％和８７％。作者认为：颈椎损伤早期应采用颈椎侧位片、前后位片及枢椎齿状突开口位片作为放射学常规检查；对于常规放射学检查或临床表现提示有颈椎损伤者以及根据常规放射学检查难以确定诊断者，应考虑行断层扫描、ＣＴ扫描及ＭＲＩ检查

Initial radiographic evaluation of cervical spine injuries:Study of diagnostic value/

The standard radiographic views (lateral,anteroposterior and openmouth odontoid views)of 152 patients suspected with acute cervical spine injury were compared with tomography,CT scan and MRI.Cervical fractrues were detected in 87(57 2%)of the 152 patients.The lateral view had a sensitivity of 84 0%,specificity of 74 0%,and accuracy of 80 0%for diagnosis.The three standard views had a corresponding sensitivity,specificity,and accuracy of 93 0%,80 0% and 87 0%,respectively.It is considered that the threeviews are recommended as the initial routine for radiographic evaluation of cervical spine injuries.Any patients whose initial plain films or clinical findings indicate cervical spine injuries or whose routine radiograms fail to determine the diagnosis,tomography,CT scan or MRI should be employed for further evaluation.