Roentgenographic Diagnosis of Glass Foreign Bodies

創傷傷口常可見到玻璃碎片殘留。然而因為各種文獻的論點分歧，大部份的醫師並不確定這些玻璃碎片是否能以X光來發覺。因此設計與執行本研究來試圖解答：（1）一般的X光攝影是否能發覺玻璃碎片？（2）不同種類的玻璃是否有所差異？以及（3）攝影時重疊的骨骼會有甚麼影響？玻璃就其化學成份的不同可以分成四大類：明板玻璃、色板玻璃、反射玻璃與鏡板玻璃。本研究採用九種足以代表此四大分類的玻璃樣品，敲碎後將其分別置放於豬腳的皮下組織。首先以一般X光攝影、再以電腦斷層攝影來研究不同種類玻璃是否皆能呈像，以及它們之閒是否有所差異。接著再選用斷層射影所得呈像指數最低的玻璃，將不同尺寸的碎片置入豬腳的皮下組織，以一般X光攝影來研究其診斷的極限與骨骼所造成的影響。雖然色板玻璃、反射玻璃以及鏡板玻璃中使用的金屬成份使得它們比明板玻璃有較高的斷層攝影呈像指數，然而一般的X光攝影多能清楚地顯像而沒有顯著差異。即使是小到1mm的玻璃碎片，只要不受到骨骼的干擾，都能夠以一般X光攝影來顯像。因此，不同角度的X光攝影，是發覺創傷傷口玻璃碎片的診斷利器。

關鍵字

玻璃；異物； X光診斷

並列摘要

lass fragments are not uncommonly encountered in trauma wound. Most physicians are not sure whether they are visible on radiography or not because of controversy in literature. This study was designed to answer: (1) Is the glass visible on standard roentgenogram? (2) Is there any difference in different kinds of glass? and (3) What's the effect of overlying bone on glass fragment? Four chemically elementary classes of glass, clear, tinted, reflective and mirror glass were used for this study. Nine glass samples were broken into pieces and then driven into the subcutaneous tissue of cadaveric pig. Standard radiography film was taken on different kinds of glass first. Then, computed tomography was undertaken to determine their individual Hounsfield value. Finally, different size of plain glass (clear glass) which has the lowest Hounsfield value were used to assess the limitation of standard roentgenogram and the effect of obscuration by overlying bone. Different kinds of glass did not have the visibility difference on standard roentgenogram, though the metal compounds used in the tinted, reflective, and mirror glass had made their Hounsfield values higher than plain glass. Thin glass fragment as small as 1mm can be easily visible roentgenographically if it is not obscured by bone. Different views of standard roentgenogram should provide a good diagnostic aids for glass foreign bodies in trauma wound.

並列關鍵字

glass ； foreign body ； roentgenographic diagnosis

國際替代計量

Roentgenographic Diagnosis of Glass Foreign Bodies

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