Andresen R, Radmer S, Brossmann J, Sartoris D J, Sparmann M, Bogusch G, Banzer D
Röntgen- und Nuklearmedizinische Abteilung, Städtisches Krankenhaus Zehlendorf, Freie Universität Berlin.
Rofo. 1998 Jul;169(1):53-7. doi: 10.1055/s-2007-1015049.
Examination of the ability to image fractures of the body and hook of the hamate bone in conventional X-rays and HR-CT.
In an in vitro experiment on 18 cadaver hands, the hamate bone was fractured at different localisations. Before and after fracture, conventional x-rays were taken in different projectional planes: a.-p., lateral, oblique and carpal tunnel view, as well as an HR-CT with 2 mm layer thickness in the axial, sagittal and coronal plane. In addition, 15 clinically verified hamate bone fractures (two body and 13 hook of hamate fractures) were reviewed retrospectively to assess the value of the imaging procedures that led to diagnosis.
Taking into account all conventional x-ray projections applied, the in vitro experiment yielded a sensitivity of 72.2%, a specificity of 88.8% and an accuracy of 80.5%. For CT, the sensitivity was 100%, the specificity 94.4% and the accuracy 97.2%. In retrospective clinical evaluation, 60% of the existing fractures were identified in the conventional x-ray images. The remaining fractures were detected by additional procedures like scintigraphy, conventional tomography and CT.
For the diagnosis of fractures of the body and hook of the hamate HR-CT is the imaging procedure of choice, in which case an axial or sagittal plane should be chosen.
检查在传统X线和高分辨率CT（HR-CT）中对钩骨体部骨折进行成像的能力。
在对18具尸体手进行的体外实验中，在不同部位造成钩骨骨折。骨折前后，在不同投照平面拍摄传统X线片：前后位、侧位、斜位和腕管位，以及在轴向、矢状面和冠状面进行层厚2mm的HR-CT扫描。此外，回顾性分析15例经临床证实的钩骨骨折（2例钩骨体部骨折和13例钩骨钩骨折），以评估导致诊断的成像检查方法的价值。
综合应用所有传统X线投照，体外实验的敏感性为72.2%，特异性为88.8%，准确性为80.5%。对于CT，敏感性为100%，特异性为94.4%，准确性为97.2%。在回顾性临床评估中，60%的现有骨折在传统X线图像中被识别。其余骨折通过骨闪烁显像、传统体层摄影和CT等其他检查方法检测到。
对于钩骨体部和钩部骨折的诊断，HR-CT是首选的成像检查方法，在这种情况下应选择轴向或矢状面。
