数字化体层融合摄影技术在骨创伤中的应用

目的 探讨基于平板探测器的数字化体层融合技术(digital tomosynthesis,DTS)在骨创伤中的应用价值。 方法 对于2014年5月-2015年5月期间蚌埠医学院第一附属医院门急诊收治的60例骨创伤患者,首诊进行常规的DR检查,但无法明确诊断是否有骨折,随后对其运用数字化体层融合X线摄影技术(DTS)进行检查;另外对5例骨折后行内外固定术的患者同时进行常规DR和数字化体层融合摄影检查,所得图像传入影像工作站,再由放射科2位高年资医师阅片观察,对比分析两种不同检查方法所得到的图像资料。 结果 65例患者的DR摄影优片率达44.61%(29/65),DTS技术摄影优片率达64.62%(42/65);60例DR检查无法明确诊断的患者中,13例通过DTS技术摄影可明确发现微小隐匿性骨折,37例未发现明确的骨折,另外10例患者仍无法明确是否骨折,需进行进一步检查以明确诊断。此外,5例骨折内外固定术后患者DTS摄片中外固定石膏托和内固定金属植入物伪影明显减少。 结论 DTS在骨创伤的检查中,相比常规的DR检查,不仅提高了影像质量,而且提高隐匿性骨折诊断率,对于骨创伤患者术后,可以减少金属植入物或其他外固定物的伪影。因此,DTS在骨创伤患者的术前检查和术后复查中均具有重要的应用价值。 

Application of digital tomosynthesis in the imaging diagnostics of skeletal trauma

Objective To study the application of Digital Tomosynthesis (DTS) based on flat panel detector (FPD) in the detection of skeletal trauma. Methods From May, 2014 to May, 2015, 60 cases of skeletal trauma admitted to our hospital emergency all received the examination with Digital Radiography, who received the examination with Digital Tomography if the radiological diagnosis was not clear. The original data of every layer were calculated and processed. Two radiologists reviewed all the images and diagnosed in consensus. Results The good rate of DR images were 44.61% (29/65), while DTS images were 64.62% (42/65). Of the 60 patients who could not be diagnosed clearly by DR, 13 cases were diagnosed with subtle occult fracture by DTS technique, and 37 cases had no definite fracture, and the other 10 patients were still unable to determine whether or not they were fractured. Further examination was needed to confirm the diagnosis. In addition, the artifacts due to external fixation plaster and metal implants were significantly reduced in the DTS films from 5 patients after fracture surgery. Conclusion Digital Tomosynthesis (DTS) can not only improve the quality of images, but also improve the diagnostic rate of occult fractures in bone trauma examination, compared with conventional DR examination. And the artifacts of metal implants or other external fixators can be reduced significantly for patients after fracture surgery. Therefore, DTS has important application value in preoperative examination and postoperative reexamination of patients with bone trauma.