Deyle Simone, Wagner Andreas, Benneker Lorin Michael, Jeger Viktor, Eggli Stefan, Bonel Harald M, Zimmermann Heinz, Exadaktylos Aris K
Department of Emergency Medicine, University Hospital Bern, Switzerland.
J Trauma. 2009 Feb;66(2):418-22. doi: 10.1097/TA.0b013e31818a5d1a.
ATLS Guidelines recommend single plain radiography of the chest and pelvis as part of the primary survey. Such isolated radiographs, usually obtained by bedside machines, can result in limited, low-quality studies that can adversely affect management. A new digital, low-radiation imaging device, the "Lodox Statscan" (LS), provides full-body anterior and lateral views based on enhanced linear slot-scanning technology in just over 5 minutes. We have the first LS in Europe at our facility. The aim of this study was to compare LS with computed tomographic (CT) scanning, as the gold standard, to determine the sensitivity of LS investigation in detecting injuries to the chest, thoracolumbar spine, and pelvis from our own experience, and to compare our findings with those of conventional radiography in the literature.
We performed a retrospective chart analysis of 245 patients with multiple injuries examined by full-body LS imaging and CT scans between October 1, 2006 and October 1, 2007 at our facility. Patients under the age of 16 years were not included. LS and CT images of chest injuries, injuries to the thoracolumbar spine, and fractures of the pelvis were compared. At our facility, we no longer perform plain radiography for C-spine and head injury, but perform CT scans according to the Canadian rules. Findings with LS were also compared with those reported for conventional radiography in the literature.
Compared with CT scanning, sensitivity and specificity of full-body digital X-ray of blunt chest trauma were 57% and 100%, respectively, thoracic spinal injury 43% and 100%, lumbar spine lesions 74% and 100%, and pelvic injury 72% and 99%. The positive and negative predictive value of LS imaging were 99% and 90% for blunt chest trauma, 100% and 93% for overall spinal injuries, and 90% and 97% for pelvic injuries.
Full-body radiography with LS visualizes skeletal, chest, and pelvic pathologies "all-in-one." This low-radiation technology detected chest, thoracolumbar spine, and pelvic injuries with an overall sensitivity of 62% and a specificity of 99%. Compared with figures in the literature, LS was more accurate than conventional X-rays. A prospective randomized study is warranted to support these data.
高级创伤生命支持（ATLS）指南推荐在初级评估中对胸部和骨盆进行单次普通X线摄影。这种通常由床边设备获取的孤立X线片可能会导致检查受限、质量低下，进而对治疗产生不利影响。一种新型数字低辐射成像设备“Lodox Statscan”（LS），基于增强线性狭缝扫描技术，在短短5分钟多一点的时间内就能提供全身正位和侧位影像。我们机构拥有欧洲首台LS设备。本研究的目的是将LS与作为金标准的计算机断层扫描（CT）相比较，根据我们自己的经验确定LS检查在检测胸部、胸腰椎和骨盆损伤方面的敏感性，并将我们的研究结果与文献中传统X线摄影的结果进行比较。
我们对2006年10月1日至2007年10月1日期间在我们机构接受全身LS成像和CT扫描的245例多发伤患者进行了回顾性病历分析。不包括16岁以下的患者。比较了胸部损伤、胸腰椎损伤和骨盆骨折的LS图像与CT图像。在我们机构，对于颈椎和头部损伤不再进行普通X线摄影，而是根据加拿大规则进行CT扫描。还将LS的检查结果与文献中报道的传统X线摄影的结果进行了比较。
与CT扫描相比，钝性胸部创伤的全身数字X线摄影的敏感性和特异性分别为57%和100%，胸椎损伤为43%和100%，腰椎损伤为74%和100%，骨盆损伤为72%和99%。LS成像对钝性胸部创伤的阳性和阴性预测值分别为99%和90%，对总体脊柱损伤为100%和93%，对骨盆损伤为90%和97%。
使用LS进行全身X线摄影可“一站式”显示骨骼、胸部和骨盆病变。这种低辐射技术检测胸部、胸腰椎和骨盆损伤的总体敏感性为62%，特异性为99%。与文献中的数据相比，LS比传统X线更准确。有必要进行一项前瞻性随机研究来支持这些数据。
