DR双能量减影对胸部骨折的诊断价值评价.docVIP

DR双能量减影对胸部骨折的诊断价值评价摘要：目的 探讨DR双能量减影对胸部骨折的诊断价值。方法 以124例行胸部DR检查患者临床资料为研究对象，分析DR平片和DR减影片诊断胸部骨折的真实性、可靠性。结果 124例患者中的94例患者共确诊骨折116处，DR减影诊断的灵敏性（94.8%）和特异性（96.7%）均明显高于DR平片（72.4%，63.3%），误诊和漏诊率较低。DR减影图像的正确诊断指数91.5%，符合率85.2%，Kappa系数0.868，都明显高于DR平片。结论 DR双能量减影图像空间分辨率和对比度都较好，能有效分离骨组织和软组织，对胸部骨折诊断的敏感性、特异性都很高，值得临床广泛推广使用。关键词：数字化X线摄影；双能量减影；胸部骨折；诊断价值Diagnostic Value Evaluation of DR Dual Energy Subtraction Shadow on Chest FractureLIU Zeng-bin（Department of Radiology， The Second Peoples Hospital of Xindu District， Chengdu 610500，Sichuan，China）Abstract：Objective To investigate the diagnostic value evaluation of DR dual energy subtraction shadow on chest fracture. Methods Taking the clinical data of 124 patients underwent chest DR scan as the research object， the diagnostic authenticity and reliability of DR plain film and DR subtraction film on thoracic fracture were evaluated. Results 116 places fractures of 94 patients in 124 patients were diagnosed. Both the sensitivity （94.8%） and specificity （96.7%） of DR subtraction were significantly higher than DR flat （72.4%， 63.3%） with lower misdiagnosis and missed diagnosis rates. The correct diagnosis index of DR subtraction images was 91.5%， the coincidence rate was 85.2%， Kappa coefficient was 0.868， which were significantly higher than the DR flat. Conclusion DR dual energy subtraction image exhibits better spatial resolution and contrast， which can effectively separate the bone and soft tissue of the chest， the diagnosis sensitivity and specificity for fractures are very high， it is worth of clinical popularizing.Key words：Digital X-ray photography； Dual energy subtraction； Chest fracture； Diagnosis value数字化X 线摄影（DR）中双能量减影（DES）技术是以光电效应和康普顿散射原理为基础，使用两种高低不同的能量，让患者在一次屏气中曝光1次，得到1幅高能图像和1幅标准图像，通过软件将两幅图像相减处理，除去图像中不同吸收系数的组织，得到1副仅含软组织或骨组织的图像，使DR图像变得清晰、明了，方便观察[1]。本组研究以124例因行胸部外伤而行DR检查患者临床资料为研究对象，探讨DR双能量减影技术对胸部骨折的诊断价值，现报道如下。1 资料与方法1.1一般资料 124例患者均为2012年8月～2014年8月我院收治的胸部外伤患者，其中男性70例，女性54例，年龄18～79岁，平均（40.2±6.9）岁。124例患者全部临床资料完整，其中68例为交通伤，44例为跌落、摔伤、挤压伤或硬