#x-ray##digital
radiography##medical device# At present, with the rapid development of
construction, transportation, etc. All kinds of accidents occurred frequently
in our country, among them, the rise in chest trauma is very obvious. Our
various accidents occur frequently, which is very significant increase in chest
trauma. According to investigation statistics. Materials and Methods Chest
trauma, rib fractures highest incidence, accounting for about 87.6% ⋯. This
study was to explore the clinical value of DR photography rib fracture
diagnosis, retrospectively analyzed the clinical data of 204 cases of patients
with rib fractures, the results reported below.
Materials
and Methods
Select
from June 2013 to June 2014 rib fractures were treated in our hospital 204
cases of the study, the clinical symptoms are manifested as pain when squeezing
chest pain when coughing and breathing becomes stronger Some patients exist
local swelling, congestion phenomenon, at the same time with the difficulties.
204 cases of patients, male 140 cases, female 64 cases; age of 19.73 years,
mean (46.4 ± 5.2) years. Because of traffic accidents resulting in rib
fractures in patients 98 cases. Accounting for 48.04%; 52 cases of patients
with fractures caused by falls, accounting for 25.49%; 44 cases was caused by
assault, accounting for 21.57%; 10 cases was due to other causes. Accounting
for 4.90%. All patients underwent routine x-ray examination after the line DR
photography.
The method
will be set in the value DR diagnosis of 141 kV, and the use of AEC automatic
exposure, obtain the data sent to the server in order to obtain an image.
Conventional x-ray exposure conditions for 65.85 kv, mAs of 12.5 ~ 25 mAs. When
using two methods for diagnosis, all patients were treated with the same
position, so that more scientific and accurate discussion of the differences
between the two late. To shoot a film close to the injured area, including the
position left, right position and standing position, the patient in this
process need breath, and after the diaphragm, the diaphragm rib sheet printed
out separately. May exist for patients with fractures, it is necessary to
increase beat their left anterior or right anterior oblique ribs. For chest
X-ray did not explicitly shown in patients with fractures and clinical symptoms
were consistent with, and they have taken the line tangential way, and pay
attention to the alignment of the thoracic tangent point tenderness. You can
select the appropriate position on the basis of the patient's own specific
circumstances. And then arrange several senior doctors to analyze the ribs
image for final confirmation, then you can refer to the following criteria: ①
complete fracture: fracture line runs through the ribs cortex, and there are
angled at its ends, and inserted into the phenomenon of displacement; ②
Incomplete fracture: Trauma and Injury obvious location is more suspicious,
while there is one side of the cortex uplift or breakage.
A closer
look at patient x-ray showing what characteristics. While recording with
conventional x-ray photography for clinical diagnosis rate DR rib fracture
diagnosis, misdiagnosis rate.
Methods to
summary and analysis of the data, using SPSS 17.0 software for statistical
processing, count data using the number of cases and percentage.. Comparative
Application x2 test, with P <0.05 indicates a statistically significant
difference.
Result
According
to test results showed the fracture, rib fractures in 204 patients. A total of
398 the number of fractures. Which it is located 247 arch rib fractures,
located in front of the rib has 55, located behind the ribs there are 96.
Divided according to the degree of fracture, incomplete fracture patients have
58 cases. The remaining 146 cases, compared with patients with complete
fractures.
Conventional
× optical initial diagnosis of rib fracture results in comparison with the DR
204 cases when patients with newly diagnosed, conventional x-ray diagnosis was
81.16%, misdiagnosis rate was 18.84%; DR Photography diagnosis rate of 92.46
percent, missedIt was 7.54%, significantly different statistically significant
(P <0.05).
Discuss
Since the
ribs for the bow, and in the broader scope of the chest and abdomen are
rendered as curved space, and basically take shape gradually inclined from the
upper portion at the front, increasing to 9 ribs at the start decreasing. By
its form on, people once suffered chest injuries, rib fractures are much more.
Because older children rib elastic and therefore less fracture phenomena and
adults, the elderly due to the gradual decline in function, loose between the
ribs, with greater brittleness. Therefore, multiple fractures in adults and the
elderly. Rib fractures affected how and where the force, the final results are
different, for example if due to external violence, once broken bones, the end
result may appear the phenomenon of blood pneumothorax or chest wall hematoma.
Both Jl green shape with respect to a serious threat to human life. The
application of conventional x-ray to check, because of its film and processing
times longer, there may be delays in the best timing of treatment. Based on
this, DR digital imaging system has been widely used. DR direct digital
photography is photography, first underwent x-ray capture, and image data
obtained after the images are stored in the board. Then after reading through
the means, the image displayed on the computer after the conversion process by
grayscale images will be displayed. It is capable of image latitude, sharpness
and contrast adjustment, can effectively compensate for the lack of
conventional x-ray.
For
conventional x-ray, most fractures are able to diagnose. For some of the more
minor fracture Missed appears obvious place, mainly due to the rib shape, X-ray
density is not high resolution and image overlay effects. Then lead to medical
disputes. The DR photography with the higher density resolution and exposure
latitude, for tissue density difference of less than 1% of the object can tell
the difference. Therefore DR Photography can get richer and clearer than
conventional x-ray image. In the present study, when 204 cases of newly
diagnosed patients, conventional x-ray diagnosis was 81.16%, DR photographic
diagnosis was 92.46%. And then visit, conventional X-ray diagnostic rate was
69.33%. DR diagnosis was 90.00%, compared to a significant difference (P
<0.05). The results of the present results with the Luo evening glow
similar. Thus, the application of DR photography has a high detection rate when
diagnosing rib fracture.
In this
study. Missed or there. When diagnosed, conventional x-ray missed diagnosis
rate was 18.84%; DR Photography missed diagnosis rate was 7.54%. Then referral,
conventional x-ray missed diagnosis rate was 30.67%, DR misdiagnosis rate of
1,000 percent. After clinical analysis.It found that there may be several
reasons: ① ribs were many pleural effusion
covered. Affect its display; ② tissues
and organs below the diaphragm ribs and overlaps difficult to show fracture
status: ③ intense pain fracture patients, it is
difficult with the physician rotated position, resulting in the axillary line
rib angle is difficult to display. At the same time exposure conditions. Appropriate
exposure conditions and position. While adhering film-reading system, making
the choice of complementary inspection methods. This can effectively reduce the
rate of misdiagnosis.
In
summary, the rib fractures do not exist independently in the chest, once on the
chest trauma. Pleural effusion, pulmonary contusion and complications can
occur. So for rib fractures in patients with more severe cases, it is
recommended to use DR photography mode. DR Photography can effectively improve
the detection rate, less time-consuming, with high clinical value, should be
introduced.
Beijing World Great Trade
Co.,Ltd.
Tel:
86 10 64154668
Skype:
sun.sandy
Linkedin:
Sandy Sun
Email:
sandy.sun@worldgreat.cn
Address: West zone, Long Lake Paradise Walk, Changying, Beijing, China.
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