Department of Medical Physics, Faculty of Medicine, University of Crete, P.O. Box 2208, Iraklion 71003, Crete, Greece.
Eur J Radiol. 2010 Jul;75(1):82-6. doi: 10.1016/j.ejrad.2009.03.024. Epub 2009 Apr 15.
The aim of the current study was to compare the diagnostic information obtained from a helical CT examination in low severity cervical spine trauma with that from a lateral CT scout view. We included alert and clinically stable patients, who had suffered acute blunt trauma of low or moderate severity. Their scout images were interpreted independently by two radiologists and the final outcome of the CT exam which was the gold standard. Patient dose was assessed using Monte-Carlo techniques. In 52 of our studies (45%), at least the first five cervical vertebrae were visible with adequate quality, and in 16.5% of the scout views (19 studies) all 7 vertebrae were depicted with excellent quality. Overall sensitivity and specificity of scout view was 70% and 100%, respectively. There were three false negative and one false positive cases. The effective dose value was estimated to be 0.02 mSv which is at least two orders of magnitude lower than that from a CT scan. When clinical examination is not suggestive of a C1-C2 fracture, adequate depiction of an intact cervical spine at the scout view, without proceeding to a full CT scan, is a sufficient dose and time-effective imaging approach.
本研究旨在比较低严重程度颈椎创伤的螺旋 CT 检查与侧位 CT 初步检查获得的诊断信息。我们纳入了意识清醒且临床稳定的、遭受过中低程度急性钝性创伤的患者。他们的初步影像由两位放射科医生独立解读，最终的 CT 检查结果为金标准。使用蒙特卡罗技术评估患者剂量。在我们的 52 项研究中（45%），至少可以看到前 5 个颈椎，且质量足够好，而在 16.5%的初步影像中（19 项研究），所有 7 个椎体均以极好的质量显示。初步影像的整体敏感性和特异性分别为 70%和 100%。有 3 例假阴性和 1 例假阳性病例。有效剂量值估计为 0.02mSv，比 CT 扫描低至少两个数量级。当临床检查不提示 C1-C2 骨折时，初步影像能充分显示完整的颈椎，而无需进行全面的 CT 扫描，这是一种充分且有效的剂量和时间的影像学方法。
