Manthey D E, Storrow A B, Milbourn J M, Wagner B J
Joint Military Medical Centers Emergency Medicine Residency, San Antonio, Texas, USA.
Ann Emerg Med. 1996 Jul;28(1):7-9. doi: 10.1016/s0196-0644(96)70130-0.
To determine the usefulness of ultrasound and radiography in detecting foreign bodies in soft-tissue models closely duplicating puncture-wound trauma and hand anatomy.
In this randomized, blinded descriptive study, two radiologists independently evaluated 120 chicken thighs for foreign bodies with the use of standard two-view radiography and 7.5-MHz transducer ultrasonography. All chicken thighs were manipulated with hemostats to ensure uniform tissue damage. In 60 thighs, one foreign body had been inserted (10 each: gravel, metal, glass, cactus spine, wood, and plastic).
The sensitivity of ultrasound in detecting gravel was 40%, that for metal was 45%, that for glass was 50%, that for cactus spine was 30%, that for wood was 50%, and that for plastic was 40%. The overall sensitivity, specificity, and false-negative and false-positive rates for ultrasound were 43%, 70%, 50%, and 30%, respectively. No individual foreign body had an ultrasound detection rate of 50%. Radiography detected foreign bodies generally considered radiopaque (gravel, glass, metal) 98% of the time, but it never detected bodies considered radiolucent (wood, plastic, cactus spine). The false-negative and false-positive rates for radiography were 50% and 1.6%, respectively.
Ultrasound detection of foreign bodies by skilled operators in this animal model revealed poor sensitivity and specificity. Radiographic detection was highly sensitive for foreign bodies considered radiopaque. Our data suggest that ultrasound should not be relied on to rule out the possibility of a retained foreign body in the distal extremities.
确定超声和X线摄影在检测与穿刺伤创伤及手部解剖结构极为相似的软组织模型中的异物时的效用。
在这项随机、盲法描述性研究中，两名放射科医生分别使用标准的双视图X线摄影和7.5兆赫探头超声对120只鸡大腿进行异物评估。所有鸡大腿均用止血钳进行处理，以确保组织损伤均匀。在60只鸡大腿中，每只插入一种异物（每种10只：砾石、金属、玻璃、仙人掌刺、木头和塑料）。
超声检测砾石的敏感度为40%，检测金属为45%，检测玻璃为50%，检测仙人掌刺为30%，检测木头为50%，检测塑料为40%。超声的总体敏感度、特异度、假阴性率和假阳性率分别为43%、70%、50%和30%。没有单个异物的超声检测率达到50%。X线摄影检测通常被认为是不透射线的异物（砾石、玻璃、金属）的时间为98%，但从未检测到被认为是透射线的异物（木头、塑料、仙人掌刺）。X线摄影的假阴性率和假阳性率分别为50%和1.6%。
在这个动物模型中，熟练操作人员用超声检测异物的敏感度和特异度较差。X线摄影对不透射线的异物检测高度敏感。我们的数据表明，不应依靠超声来排除远端肢体残留异物的可能性。
