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床边超声检查在腕部损伤患者中的效率及与其他放射学成像方法的比较:一项前瞻性研究。

The efficiency of bedside ultrasonography in patients with wrist injury and comparison with other radiological imaging methods: A prospective study.

作者信息

Oguz Ahmet Burak, Polat Onur, Eneyli Muge Gunalp, Gulunay Behnan, Eksioglu Merve, Gurler Serdar

机构信息

Gumushane State Hospital, Department of Emergency, Gumushane, Turkey.

Ankara University School of Medicine, Department of Emergency Medicine, Ankara, Turkey.

出版信息

Am J Emerg Med. 2017 Jun;35(6):855-859. doi: 10.1016/j.ajem.2017.01.043. Epub 2017 Jan 26.

Abstract

STUDY OBJECTIVE

Our aim was to determine the efficiency of ultrasound (US) scanning in patients with wrist trauma admitted to the emergency department and to compare US diagnostic usage with other radiological imaging methods.

METHODS

Patients who presented to the emergency department with wrist injury and who met the inclusion criteria and exclusion criteria were eligible. For all patients, US evaluation of the whole wrist was performed by an emergency physician before other radiological imaging methods (radiographies, computed tomography (CT) and magnetic resonance (MR) imaging). All of the patients included in the study underwent US, radiography, CT, and MR.

RESULTS

During the study, 122 patients were admitted with a wrist injury. After filtering for the exclusion criteria, 80 patients were included in the study. The sensitivity of US scanning in detecting fractures was 95.31% (95% confidence interval [CI]: 87.1-98.39), the specificity was 93.75% (95% CI: 71.67-98.89), and the positive predictive value was 98.39% (95% CI: 91.72-99.85), and the negative predictive value was 83.33% (95% CI: 72.98-90.41). The sensitivity of US scanning in detecting tendon and ligamentous structural injury was 66.67% (95% CI: 41.71-84.82), the specificity was 100% (95% CI: 94.42-100), the positive predictive value was 100% (95% CI: 94.29-99.89), and the negative predictive was 92.86% (95% CI: 84.25-97.14).

CONCLUSION

US scanning is an effective method that can be applied in the emergency department to adult patients to diagnose distal forearm and carpal bones fractures. In soft tissue injuries, US and MR examinations produce similar results.

摘要

研究目的

我们的目的是确定急诊科收治的腕部创伤患者中超声(US)扫描的效率,并将US诊断用途与其他放射成像方法进行比较。

方法

因腕部损伤就诊于急诊科且符合纳入标准和排除标准的患者符合条件。对于所有患者,在进行其他放射成像方法(X线摄影、计算机断层扫描(CT)和磁共振(MR)成像)之前,由急诊医生对整个腕部进行US评估。纳入研究的所有患者均接受了US、X线摄影、CT和MR检查。

结果

研究期间,122例患者因腕部损伤入院。经过排除标准筛选后,80例患者纳入研究。US扫描检测骨折的敏感性为95.31%(95%置信区间[CI]:87.1 - 98.39),特异性为93.75%(95% CI:71.67 - 98.89),阳性预测值为98.39%(95% CI:91.72 - 99.85),阴性预测值为83.33%(95% CI:72.98 - 90.41)。US扫描检测肌腱和韧带结构损伤的敏感性为66.67%(95% CI:41.71 - 84.82),特异性为100%(95% CI:94.42 - 100),阳性预测值为100%('95% CI:94.29 - 99.89),阴性预测值为92.86%(95% CI:84.25 - 97.14)。

结论

US扫描是一种可应用于急诊科成年患者诊断前臂远端和腕骨骨折的有效方法。在软组织损伤方面,US和MR检查结果相似。

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