Berná Juan D, Chavarria German, Albaladejo Francisco, Meseguer Luis, Pellicer Arturo, Sánchez-Cañizares Miguel A, Pérez-Flores Domingo
Department of Radiology, University General Hospital, C.E.P. Quesada Sanz c/Dr. Quesada Sans s/n, Murcia 30005, Spain.
AJR Am J Roentgenol. 2004 Jan;182(1):155-9. doi: 10.2214/ajr.182.1.1820155.
The objective of this study was to compare the diagnostic value of panoramic and conventional radiography in the detection of fractures of the carpal scaphoid bone.
Panoramic (orthopantomographic) and conventional radiographs of 90 patients with acute or chronic wrist trauma were reviewed retrospectively. Images were analyzed and reviewed independently by four observers: two radiologists and two traumatologists. The kappa statistic was used to calculate intraand interobserver agreement and the correlation between the two imaging techniques.
Panoramic radiography of the wrist was superior to conventional radiography in ruling out scaphoid fractures (74%, 20/27) in patients with suspicious findings on conventional radiography; revealed more cases of scaphoid fractures (21.4%, 12/56); and revealed more cases of delayed union (n = 2), nonunion (n = 3), and union (n = 3). Agreement values were higher, with better inter- and intraobserver agreement, for the panoramic examinations than for the conventional radiographic examinations.
The panoramic examination of the wrist is a useful technique for the diagnosis and follow-up of scaphoid fractures. Its use is recommended as a complement to conventional radiography in cases with inconclusive findings.
本研究的目的是比较全景X线摄影和传统X线摄影在检测腕舟骨骨折中的诊断价值。
回顾性分析90例急性或慢性腕部创伤患者的全景（曲面断层）X线片和传统X线片。由四名观察者独立分析和评估图像，其中两名放射科医生和两名创伤科医生。使用kappa统计量计算观察者内和观察者间的一致性以及两种成像技术之间的相关性。
在传统X线摄影有可疑发现的患者中，腕部全景X线摄影在排除舟骨骨折方面优于传统X线摄影（74%，20/27）；发现更多舟骨骨折病例（21.4%，12/56）；并发现更多延迟愈合（n = 2）、不愈合（n = 3）和愈合（n = 3）病例。全景检查的一致性值更高，观察者间和观察者内的一致性均优于传统X线检查。
腕部全景检查是诊断和随访舟骨骨折的一种有用技术。在结果不明确的情况下，建议将其作为传统X线摄影的补充手段使用。
