Lee Sangdon, Gray Frances, Jimenez Yobelli, Said Susan, Moore Cameron
Discipline of Medical Imaging Science, Faculty of Medicine and Health, The University of Sydney, Camperdown, New South Wales, Australia.
Radiology, Westmead Hospital, Westmead, New South Wales, Australia.
J Med Radiat Sci. 2025 Sep;72(3):376-384. doi: 10.1002/jmrs.70004. Epub 2025 Jun 29.
Pelvic x-rays can be conducted on a trauma trolley or conventional table bucky. The aim of this study was to compare the positional challenges and reject rate between pelvic x-ray images taken on a trauma trolley and a table bucky during a 12-month period in an Australian public metropolitan hospital's emergency department and to determine the accuracy rate of anatomical inclusion via a qualitative assessment of pelvic x-rays using a modified Visual Grading Scale (VGS).
A retrospective clinical audit of pelvic x-ray image reject rates over a 12-month period was conducted for an emergency department at an Australian hospital. Reject rate and anatomical cut-off were compared between images taken on a trauma trolley and a table bucky using independent samples t-test.
A total of 1847 patients who underwent pelvic x-ray examinations were included in the study. The mean reject rate and the first exposure accuracy of pelvis x-rays taken on a trauma trolley were 35.5% and 56.7% respectively, while the mean reject rate and the first exposure accuracy for images taken on a table bucky were 18.8% and 81.8%, respectively (p < 0.01). The superior and lateral anatomy cut-off were the major causes of image rejection for both techniques.
Pelvic x-rays taken on a trauma trolley had a significantly higher reject rate and lower first exposure accuracy compared with those taken on an x-ray table. Future studies could involve implementing strategies to reduce the reject rate of pelvic x-rays taken on trauma trolleys.
骨盆X光检查可在创伤推车上或传统检查台滤线栅上进行。本研究的目的是比较在澳大利亚一家公立大都市医院急诊科的12个月期间，在创伤推车上和检查台滤线栅上拍摄的骨盆X光图像的定位挑战和拒收率，并通过使用改良视觉分级量表（VGS）对骨盆X光进行定性评估来确定解剖结构包含的准确率。
对澳大利亚一家医院急诊科12个月期间骨盆X光图像拒收率进行回顾性临床审计。使用独立样本t检验比较在创伤推车上和检查台滤线栅上拍摄的图像的拒收率和解剖结构截断情况。
共有1847例接受骨盆X光检查的患者纳入研究。在创伤推车上拍摄的骨盆X光的平均拒收率和首次曝光准确率分别为35.5%和56.7%，而在检查台滤线栅上拍摄的图像的平均拒收率和首次曝光准确率分别为18.8%和81.8%（p<0.01）。两种技术中，上部和外侧解剖结构截断是图像拒收的主要原因。
与在X光检查台上拍摄的骨盆X光相比，在创伤推车上拍摄的骨盆X光拒收率显著更高，首次曝光准确率更低。未来的研究可涉及实施策略以降低在创伤推车上拍摄的骨盆X光的拒收率。
