Jöres A P W, Heverhagen J T, Bonél H, Exadaktylos A, Klink T
University Institute of Diagnostic, Interventional and Pediatric Radiology, Inselspital - University Hospital Bern, Switzerland.
Department of Emergency Medicine, Inselspital - University Hospital Bern, Switzerland.
Rofo. 2016 Feb;188(2):163-71. doi: 10.1055/s-0041-107199. Epub 2015 Nov 3.
The purpose of this study was to evaluate the diagnostic accuracy of full-body linear X-ray scanning (LS) in multiple trauma patients in comparison to 128-multislice computed tomography (MSCT).
106 multiple trauma patients (female: 33; male: 73) were retrospectively included in this study. All patients underwent LS of the whole body, including extremities, and MSCT covering the neck, thorax, abdomen, and pelvis. The diagnostic accuracy of LS for the detection of fractures of the truncal skeleton and pneumothoraces was evaluated in comparison to MSCT by two observers in consensus. Extremity fractures detected by LS were documented.
The overall sensitivity of LS was 49.2 %, the specificity was 93.3 %, the positive predictive value was 91 %, and the negative predictive value was 57.5 %. The overall sensitivity for vertebral fractures was 16.7 %, and the specificity was 100 %. The sensitivity was 48.7 % and the specificity 98.2 % for all other fractures. Pneumothoraces were detected in 12 patients by CT, but not by LS. 40 extremity fractures were detected by LS, of which 4 fractures were dislocated, and 2 were fully covered by MSCT.
The diagnostic accuracy of LS is limited in the evaluation of acute trauma of the truncal skeleton. LS allows fast whole-body X-ray imaging, and may be valuable for detecting extremity fractures in trauma patients in addition to MSCT.
The overall sensitivity of LS for truncal skeleton injuries in multiple-trauma patients was < 50 %. The diagnostic reference standard MSCT is the preferred and reliable imaging modality. LS may be valuable for quick detection of extremity fractures.
本研究旨在评估全身线性X线扫描（LS）在多发伤患者中的诊断准确性，并与128层螺旋计算机断层扫描（MSCT）进行比较。
本研究回顾性纳入了106例多发伤患者（女性33例；男性73例）。所有患者均接受了包括四肢在内的全身LS检查，以及覆盖颈部、胸部、腹部和骨盆的MSCT检查。由两名观察者共同评估LS相对于MSCT检测躯干骨骼骨折和气胸的诊断准确性。记录LS检测到的四肢骨折情况。
LS的总体敏感性为49.2%，特异性为93.3%，阳性预测值为91%，阴性预测值为57.5%。椎体骨折的总体敏感性为16.7%，特异性为100%。其他所有骨折的敏感性为48.7%，特异性为98.2%。CT检测到12例气胸，但LS未检测到。LS检测到40例四肢骨折，其中4例骨折有脱位，2例骨折MSCT完全覆盖。
LS在评估躯干骨骼急性创伤时诊断准确性有限。LS可进行快速全身X线成像，除MSCT外，对检测创伤患者的四肢骨折可能有价值。
LS对多发伤患者躯干骨骼损伤的总体敏感性<50%。诊断参考标准MSCT是首选且可靠的成像方式。LS对快速检测四肢骨折可能有价值。
