McGlinchey I, Fleet M F, Eatock F C, Raby N D
Department of Radiology, Western Infirmary, Glasgow, UK.
Clin Radiol. 1998 Mar;53(3):215-7. doi: 10.1016/s0009-9260(98)80104-9.
The aim of the study is to determine whether a two rather than a three-view skull series is adequate for diagnosis of a skull fracture given a reliable history of the site of trauma. The radiographs of 50 patients who were diagnosed and managed as having sustained skull fractures were randomly mixed with 200 normal skull series and viewed independently by three observers. For all the film series viewed (a total of 1500 for the three observers), the diagnostic confidence level for two films was 94.4%, and for three films 94.6%. Of a total of 150 skull fracture series viewed as two films, 87 (58%) were correctly diagnosed with a confidence level of 92.7%. When viewed as three films, 92 (61.3%) were correctly diagnosed with a confidence level of 93%. Combined with analysis of false-positive and false-negative results, no statistical difference could be detected between a two or three film skull series. A two-view skull series has no statistically deleterious effect on either diagnostic accuracy or confidence of interpretation when compared with a three-view series given an accurate clinical history.
本研究的目的是确定在有可靠的外伤部位病史的情况下，两张颅骨X线片而非三张颅骨X线片是否足以诊断颅骨骨折。将50例被诊断为颅骨骨折并接受相应治疗的患者的X线片与200例正常颅骨X线片随机混合，由三名观察者独立阅片。对于所有观察的X线片系列（三名观察者共观察了1500张），两张X线片的诊断置信度为94.4%，三张X线片的诊断置信度为94.6%。在总共150例被视为两张X线片的颅骨骨折系列中，87例（58%）被正确诊断，置信度为92.7%。当视为三张X线片时，92例（61.3%）被正确诊断，置信度为93%。结合假阳性和假阴性结果分析，两张或三张颅骨X线片之间未检测到统计学差异。与三张X线片系列相比，在有准确临床病史的情况下，两张颅骨X线片系列对诊断准确性或解读置信度均无统计学上的有害影响。
