Vela Jason Heath, Wertz Christopher Ira, Onstott Kimberly L, Wertz Joss R
Radiol Technol. 2017 Jan;88(3):263-276.
To inform radiologic technologists about which imaging modalities and examinations are best suited for evaluating specific anatomical structures in patients who have sustained a traumatic injury.
Two scholarly research databases were searched to identify articles focused on trauma imaging of the head, cervical spine, thorax, abdomen, and pelvis. Articles focused on trauma diagnosis were excluded. Thirty-two articles were selected for analysis.
Physical examination and plain-film radiographs typically are used to assess nasal bone fracures. Computed tomography (CT) can be used to assess zygomaticomaxillary complex, mandibular, and temporal bone fractures. Traumatic brain injuries are difficult to assess, and broad classifications are used. Depending on the severity of cervical spine trauma, plain-film radiographs or CT imaging is adequate, with magnetic resonance imaging used as a means for further evaluation. Trauma to the thorax typically is assessed with radiography and CT, and CT is recommended for assesment of abdominal and pelvic trauma.
The literature was consistent regarding which examinations to perform to best evaluate suspected injuries to the chest, abdomen, and pelvis. The need for, and correct use of, imaging in evaluating trauma to the head and cervical spine is more controversial. Despite the need for additional research, emergency department care providers should be familiar with the structures most commonly injured during trauma and the role of medical imaging for diagnosis.
告知放射技师哪些成像方式和检查最适合评估遭受创伤性损伤患者的特定解剖结构。
检索了两个学术研究数据库,以确定专注于头部、颈椎、胸部、腹部和骨盆创伤成像的文章。排除专注于创伤诊断的文章。选择了32篇文章进行分析。
体格检查和普通X线平片通常用于评估鼻骨骨折。计算机断层扫描(CT)可用于评估颧上颌复合体、下颌骨和颞骨骨折。创伤性脑损伤难以评估,采用广泛的分类方法。根据颈椎创伤的严重程度,普通X线平片或CT成像即可,磁共振成像用作进一步评估手段。胸部创伤通常通过X线摄影和CT进行评估,腹部和骨盆创伤评估建议使用CT。
关于对胸部、腹部和骨盆疑似损伤进行最佳评估应进行哪些检查,文献观点一致。在评估头部和颈椎创伤时,成像检查的必要性及正确使用更具争议性。尽管需要更多研究,但急诊科护理人员应熟悉创伤期间最常受伤的结构以及医学成像在诊断中的作用。