Orthopedic Trauma Institute, San Francisco General Hospital, University of California San Francisco, San Francisco, California 94110, USA.
J Trauma Acute Care Surg. 2013 Jun;74(6):1510-5. doi: 10.1097/TA.0b013e318292156c.
The new-generation multidetector computed tomographic (CT) scanners allow for the generation of virtual x-rays from the data acquired during the evaluation of pelvic fractures. Special software allows technicians to obtain the appropriate orientation required for adequate inlet and outlet views, which would eliminate repeat trips to the radiography suite to acquire adequate x-rays. The purpose of this study is to compare the quality virtual x-rays and conventional x-rays that are used in evaluating pelvis fractures.
A retrospective database review was performed to identify patients who were operated on with a diagnosis of pelvis fracture. The inclusion criteria were AO/OTA type B or C pelvic fractures, age older than 18 years, complete set of anteroposterior (AP) pelvis, inlet, and outlet x-rays and a multidetector pelvis CT scan. Virtual AP pelvis, inlet, and outlet views were generated from the CT scan data. Two fellowship-trained orthopedic trauma surgeons reviewed the virtual and conventional studies separately in association with CT scans and graded the quality of the studies on a custom developed questionnaire.
Twenty patients were eligible for the study. The AP pelvis image quality was similar for both conventional and virtual images except for the rotation of the pelvis, which was improved in the virtual images. The inlet and outlet image quality was better in all domains in the virtual x-ray group when compared with the conventional x-rays. The percentage of adequate inlet and outlet images was higher in the virtual x-ray group when compared with the conventional x-ray group.
The results show that the virtual inlet and outlet images consistently provided higher rates of adequate x-rays when compared with the conventional x-rays. In the evaluation of patients with pelvis fractures, the use of the virtual inlet and outlet views instead of the conventional x-rays may provide some advantages, such as decreased radiation exposure to the patient, reduced overall cost, and reduced repeat x-rays to achieve adequate views.
Diagnostic study, level V.
新一代多排螺旋 CT 扫描仪可以根据骨盆骨折评估过程中获取的数据生成虚拟 X 射线。特殊软件允许技术人员获得适当的入口和出口视图所需的适当方向，从而避免因获取足够 X 射线而多次往返放射科。本研究的目的是比较评估骨盆骨折时使用的虚拟 X 射线和常规 X 射线的质量。
回顾性数据库检索，以确定接受骨盆骨折诊断手术的患者。纳入标准为 AO/OTA 型 B 或 C 型骨盆骨折、年龄大于 18 岁、完整的前后位（AP）骨盆、入口和出口 X 射线和多排骨盆 CT 扫描。从 CT 扫描数据生成虚拟 AP 骨盆、入口和出口视图。两名 fellowship 培训的骨科创伤外科医生分别在与 CT 扫描相关的情况下单独审查虚拟和常规研究，并使用自定义开发的问卷对研究质量进行分级。
20 名患者符合研究条件。除了骨盆旋转外，常规和虚拟 AP 骨盆图像质量相似，而虚拟图像中的骨盆旋转得到了改善。与常规 X 射线相比，虚拟 X 射线组的入口和出口图像质量在所有领域都更好。与常规 X 射线组相比，虚拟 X 射线组中足够的入口和出口图像的百分比更高。
结果表明，与常规 X 射线相比，虚拟入口和出口图像始终提供更高比例的足够 X 射线。在评估骨盆骨折患者时，使用虚拟入口和出口视图而不是常规 X 射线可能具有一些优势，例如降低患者的辐射暴露、降低总体成本和减少重复 X 射线以获得足够的视图。
诊断研究，等级 V。
