- 期刊
改良式輔具在膝關節軸位攝影的回顧性臨床研究
Retrospective Clinical Study of Modified Assistive Device in Axial Photography of Knee Joint
摘要
膝關節軸位攝影又稱天線攝影，常因X光入射角與膝關節彎曲角度的關係導致髕骨歪斜，未能呈現真正的髕股關節空間。我們使用回顧性研究，數據來自於病人（其中男性213人，女性347人）的膝關節軸位影像，比較了使用A輔具（入射角為10°～15°）及使用B 輔具（入射角以水平角度投射）的髕骨空間與髕骨重疊比值（CO/CC'），比值越低代表影像品質越佳，結果顯示B輔具的平均比值為0.28±0.13低於A輔具的0.83±0.28，相較下B輔具有較佳的影像品質表現（p=0.000，＜0.05）。另外從一位放射診斷科醫師及一位骨科醫師的臨床評比來看，採用李克特氏五點量表分別從臏股空間、位置歪斜、髕骨重疊等面向進行影像品質評分，所有證據都顯示B輔具優於A輔具。其他變異項目如病人性別、年齡、左右腳及放射師年資等因素都不受影響，我們相信使用B輔具能提供較佳的影像品質，且不受多種因素影響，穩定呈現病況真貌，幫助醫師提高診斷的準確性。
並列摘要
Axial photography of the knee joint, also known as skyline photography. Deviated patella is often caused by a mismatch between the angle of incidence of the x-ray and knee flexion, affecting the appearance of the true patellofemoral joint space. We used a retrospective study with data obtained from patients (213 males and 347 females) of the knee joint axial radiographs to measure the ratio of patellar space to patellar overlap (CO/CC'), the lower the ratio, the better the image quality. Compare the differences between assistive device A (incidence angle is 10°~15°) and assistive device B (incidence angle is projected at a horizontal angle), the results show that the average ratio of assistive device B (0.83±0.28) was lower than that of assistive device A (0.28±0.13), after comparison, the assistive device B had better image quality performance (p=0.000, <0.05). In addition, from the clinical evaluation of a diagnostic radiologist and an orthopedic physician, the image quality was scored from the patellofemoral space, positional skewness, and patella overlap by using Likert's five-point scale. All evidence shows that assistive device B is better than assistive device A. Other variables such as patient gender, age, different between right and left knee joints, and the qualifications of radiological technologist are not affected. We believe that the use of assistive device B produces better and more stable image quality, which can help doctors understand disease progression and improve diagnostic accuracy.