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超声对前胸部疼痛创伤患者胸骨骨折的诊断价值

Diagnostic Value of Ultrasound for Sternal Fractures in Patients with Trauma Experiencing Anterior Chest Wall Pain.

作者信息

Park Hoonsung, Kim Maru, Lee Dae-Sang, Hong Tae Hwa, Kim Doo-Hun, Cho Hangjoo

机构信息

Division of Acute Care Surgery, Department of Surgery, Korea University Anam Hospital, Seoul 02841, Republic of Korea.

Department of Trauma Surgery, Uijeongbu St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul 06591, Republic of Korea.

出版信息

J Clin Med. 2024 Aug 29;13(17):5123. doi: 10.3390/jcm13175123.

Abstract

Ultrasound is an attractive modality for the confirmation of sternal fractures in patients with trauma because of its easy, quick, and accurate nature, as well as its increased availability for focused assessment with sonography for trauma at the bedside. We aimed to confirm the diagnostic value of ultrasonography for sternal fractures in patients with trauma, anterior chest wall pain, and tenderness. This retrospective observational study included patients visiting a single regional trauma center from March 2022 to February 2023, diagnosed with sternal fractures via chest CT and bone scans, who underwent sternal ultrasound. Twenty-six patients were divided into two groups: those with sternal fractures diagnosed with an initial chest CT scan ( = 19) and those without fractures ( = 7). Using ultrasound, 23 patients (88.5%) were diagnosed with sternal fractures. In the initial CT scan (+) group, all 19 patients (100%) were diagnosed using ultrasound. In the initial CT scan (-) group, four (57.1%) of the seven patients were diagnosed using ultrasound. In the initial CT scan (+) group, 14 (73.7%) of the 19 patients underwent bone scans and all 14/14 (100%) were diagnosed with sternal fractures. In the initial CT scan (-) group, seven (100%) patients underwent bone scans, and all were diagnosed with sternal fractures. Ultrasound is useful for the diagnosis of sternal fractures, with sensitivity of 88.5%. Therefore, in patients with blunt trauma experiencing anterior chest wall pain and tenderness, sternal ultrasonography might be helpful in diagnosing sternal fractures as an adjunct to chest CT and bone scans.

摘要

超声是一种用于确认创伤患者胸骨骨折的有吸引力的检查方式,因为它操作简便、快速且准确,并且在床边进行创伤超声重点评估时其可用性更高。我们旨在确认超声对创伤、前胸壁疼痛和压痛患者胸骨骨折的诊断价值。这项回顾性观察研究纳入了2022年3月至2023年2月期间就诊于单一地区创伤中心、经胸部CT和骨扫描诊断为胸骨骨折且接受了胸骨超声检查的患者。26例患者被分为两组:初始胸部CT扫描诊断为胸骨骨折的患者(n = 19)和未骨折的患者(n = 7)。使用超声检查,23例患者(88.5%)被诊断为胸骨骨折。在初始CT扫描阳性组中,19例患者全部(100%)通过超声检查确诊。在初始CT扫描阴性组中,7例患者中有4例(57.1%)通过超声检查确诊。在初始CT扫描阳性组中,19例患者中有14例(73.7%)接受了骨扫描,所有14例(100%)均被诊断为胸骨骨折。在初始CT扫描阴性组中,7例患者全部(100%)接受了骨扫描,且均被诊断为胸骨骨折。超声对胸骨骨折的诊断很有用,敏感性为88.5%。因此,对于有钝性创伤且伴有前胸壁疼痛和压痛的患者,胸骨超声检查作为胸部CT和骨扫描的辅助手段可能有助于诊断胸骨骨折。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6d3a/11396196/f2890004bc01/jcm-13-05123-g001.jpg

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