Danz B, Biehl C, Bähren W
Radiologische Abteilung, Bundeswehrkrankenhaus Ulm.
Rofo. 1996 Apr;164(4):269-74. doi: 10.1055/s-2007-1015654.
To determine the value of supine chest radiography in comparison to orientating chest CT in the initial diagnostic evaluation of severely polytraumatised patients.
303 patients with primary indication for a cranial CT following trauma were investigated between 1988 and 1993. After performing the cranial CT all patients underwent a chest CT with an average of 6 CT slices without changing the position of the patient and with a median scan time of 4 minutes. The results of the chest CT were correlated with the findings of the supine chest radiography in regard to therapeutically relevant pathological changes.
The sensitivity in detection of pneumothorax in supine chest radiography was 53% versus 97% in CT, atelectasis 20% versus 94%, lung contusion 79% versus 99%, haemotothorax 62% versus 97%. More fractures were found conventionally (sensitivity 94%) than by chest CT (sensitivity 44%).
Supine chest radiography of polytraumatised patients is clearly inferior to orientating chest CT in demonstrating posttraumatic lesions; obtaining therapeutically relevant information justifies the additionally needed small amount of time.
在严重多发伤患者的初始诊断评估中，确定仰卧位胸部X线摄影与胸部CT定位相比的价值。
1988年至1993年间，对303例有颅脑CT检查初步指征的创伤患者进行了研究。在进行颅脑CT检查后，所有患者均接受胸部CT检查，平均扫描6层，患者体位不变，中位扫描时间为4分钟。胸部CT结果与仰卧位胸部X线摄影在治疗相关病理改变方面的结果进行了对比。
仰卧位胸部X线摄影检测气胸的敏感性为53%，而CT为97%；肺不张为20%对94%；肺挫伤为79%对99%；血胸为62%对97%。传统方法发现的骨折（敏感性94%）比胸部CT（敏感性44%）更多。
多发伤患者的仰卧位胸部X线摄影在显示创伤后病变方面明显不如胸部CT定位；获取治疗相关信息证明额外所需的少量时间是合理的。
