直立式逆投影技術在急診外傷病患手肘側位相的應用

Erect Back Projection Technique Application of Emergency Trauma Patient Elbow Joint Lateral View

謝品安(Pin-An Hsieh)；陳建誠(Chien-Cheng Chen)；陳祥元(Hsiang-Yuan Chen)；姜義成(Yi-Cheng Chiang)；廖大富(Ta-Fu Liao)；郭進龍(Jin-Long Kuo)；張長義(Chang-Yi Chang)

肘關節 ； 正側位相 ； 逆投影技術 ； elbow joint ； true lateral view ； back projection technique

中華放射線技術學雜誌

39卷3期（2015 / 09 / 01）

153 - 158

繁體中文

急性肘關節因為外力或是運動造成損傷時，病患往往因為疼痛而無法移動，造成X光攝影擺位的困難影響診斷。本研究的目的是評估直立式逆投影技術在急診外傷病患手肘側位相的應用，我們回溯性收案主訴為肘關節受傷的急診病患，放射技師使用常規側位投影或直立式逆投影技術來攝影肘關節側位相。所有影像進行回顧性評估，由放射科醫生和放射技師獨立評分的影像品質，另外記錄總攝影時間和以視覺類比評分法測量疼痛程度。自2014年1月到6月研究期間納入80例患者，影像品質分數使用常規側位投影在右手肘為4.17 ± 0.175而左手肘為4.09 ± 0.168，使用直立式逆投影技術在右手肘為4.91 ± 0.089而左手肘為4.66 ± 0.111(p＜0.001)，人際信度為中等 (Kappa = 0.683, p＜0.001)。總攝影時間在常規側位投影與直立式逆投影技術分別為155.00 ± 64.49 與122.80 ± 69.68 秒(p＜0.05)，疼痛評分在常規側位投影與直立式逆投影技術分別為5.55 ± 0.11 與4.75 ± 0.69 (p＜0.001)。直立式逆投影技術在急診外傷病患手肘側位相是較佳的攝影方式，有較好的影像品質，使用較少的操作時間，並且造成較輕微的疼痛感。

The acute injured elbow is difficult to position in true lateral orientation due to pain and stiffness. The aim of this study was to evaluate radiographic positioning erect back projection technique for acquisition of elbow lateral projection. We prospectively enrolled patients presenting to emergency department with a primary complaint of elbow injury. The radiographers used conventional lateral projection or erect back projection technique for acquisition of the radiograph of elbow lateral projection. All images were retrospectively evaluated to score the image quality by radiologist and radiographer independently. The total procedure time was record and pain score was assessed by visual analog scale. We enrolled 80 patients during the study period between January and June in 2014. The image quality scores of conventional technique were 4.17 ± 0.175 in right elbow and 4.09 ± 0.168 in left elbow. Using erect back projection technique were 4.91 ± 0.089 in right elbow and 4.66 ± 0.111 in left elbow (p＜0.001). The interrater reliability was moderate (Kappa = 0.683, p＜0.001). The total procedure time of conventional and erect back projection technique were 155.00 ± 64.49 and 122.80 ± 69.68 second (p＜0.05). The pain score of conventional and erect back projection technique were 5.55±0.11 and 4.75±0.69 (p＜0.001). The erect back projection technique is optimizing method for acquisition of elbow lateral projection in acute injured patients with better image quality, shorter procedure time and less pain score.