Hackenbroch Carsten, Riesner Hans-Joachim, Lang Patricia, Stuby Fabian, Danz Burkhardt, Friemert Benedikt, Palm Hans-Georg
Department of Diagnostic and Interventional Radiology and Neuroradiology, German Armed Forces Hospital Ulm.
Department of Trauma Surgery and Orthopedics, Reconstructive and Septic Surgery, Sports Traumatology, German Armed Forces Hospital Ulm.
Z Orthop Unfall. 2017 Feb;155(1):27-34. doi: 10.1055/s-0042-110208. Epub 2017 Mar 1.
The incidence of fragility fractures of the pelvis is increasing. Established methods to diagnose this condition include X-rays, computed tomography (CT) and magnetic resonance imaging (MRI). Dual energy CT (DECT) is a modern technology for the imaging of bone oedema/bruises and has been used in injuries of the extremities and spine. It is unclear whether this technique can also be used in fragility fractures of the pelvis. The aim of this study was to perform a literature research and survey of the "AG Becken III" members of the German Society of Trauma Surgery (DGU) on the usefulness of DECT in fractures of the pelvis. A PubMed-based literature search on DECT comprised the key words "Dual Energy CT", "Pelvis/Pelvic", "Insufficiency" and "Fractures" and their combinations. Thirty-two publications were reviewed completely (full text). Finally, 15 articles were chosen and included in the current study. The survey of the members of the "AG Becken III" was based on a questionnaire and aimed to determine the popularity and potential benefits of DECT in comparison to established diagnostic options. No studies on the use of DECT in fragility fractures of the pelvis were identified; the few articles found referred to fractures of the extremities and spine. The response rate to the questionnaire was 25/83 (30.1 %). The participants had a mean personal experience of 8.4 years/151.6 interventions in pelvic surgery. Although some respondents had heard of DECT, this technique - if available - was only used in other indications. However, the potential benefit of DECT was recognised, especially in the acute diagnostic testing of fragility fractures. There is limited consensus on the optimal diagnostic test (CT vs. MRI) of pelvic fractures. Although DECT is already established for other indications and is regarded as a promising method by all respondents of the "AG Becken III", DECT is not yet routinely used for diagnostic testing of fragility fractures of the pelvis. Potential advantages of DECT include its greater sensitivity than CT in detecting bone oedema with equal radiation exposure. Unlike MRI, it is available 24 hours/7 days.
骨盆脆性骨折的发病率正在上升。诊断这种疾病的既定方法包括X射线、计算机断层扫描（CT）和磁共振成像（MRI）。双能CT（DECT）是一种用于骨水肿/瘀伤成像的现代技术，已用于四肢和脊柱损伤。目前尚不清楚该技术是否也可用于骨盆脆性骨折。本研究的目的是对德国创伤外科学会（DGU）的“AG Becken III”成员进行文献研究和调查，以了解DECT在骨盆骨折中的应用价值。基于PubMed的关于DECT的文献检索包括关键词“双能CT”、“骨盆/盆腔”、“骨质疏松性”和“骨折”及其组合。对32篇出版物进行了全面审查（全文）。最后，选择了15篇文章纳入本研究。对“AG Becken III”成员的调查基于一份问卷，旨在确定与既定诊断方法相比，DECT的普及程度和潜在益处。未发现关于DECT在骨盆脆性骨折中应用的研究；所发现的少数文章涉及四肢和脊柱骨折。问卷的回复率为25/83（30.1%）。参与者在骨盆手术方面的平均个人经验为8.4年/151.6次手术。尽管一些受访者听说过DECT，但这项技术（如果可用）仅用于其他适应症。然而，DECT的潜在益处得到了认可，特别是在脆性骨折的急性诊断检测中。对于骨盆骨折的最佳诊断测试（CT与MRI），共识有限。尽管DECT已用于其他适应症，并且被“AG Becken III”的所有受访者视为一种有前景的方法，但DECT尚未常规用于骨盆脆性骨折的诊断检测。DECT的潜在优势包括在同等辐射暴露下，其在检测骨水肿方面比CT具有更高的灵敏度。与MRI不同，它每周7天、每天24小时均可使用。
