頭部常規攝影對於診斷急診頭部創傷之價值

Evaluation of the Diagnostic Value of Skull Radiography for Head Injury in ER

虞榮湘(Jung-Hsiang Yu) ； 陳振德(Jen-Dar Chen) ； 葛平夷(Ping-Yi Ko) ； 張政彥(Cheng-Yen Chang)

《中華放射線技術學雜誌》 28卷2期 (2004/12) Pp. 117-126

https://doi.org/10.30045/CJRT.200412.0003

摘要

對於急診外傷病人，頭部創傷(head injury)是最常見的項目之一。頭部創傷往往會伴隨顱內出血的風險，頭部常規攝影(skull radiography)常被用作臨床診斷上最基本的檢查工具。國外有文獻指出：急診頭部創傷的病人，頭部常規攝影已無其必要性。本研究的目的則是針對本院頭部創傷的病人，評估頭部常規攝影是否仍具有臨床診斷的價值。自2003年4月至11月止，收集同時都做頭部常規攝影及電腦斷層攝影兩種檢查共100例頭部創傷的病人，進一步評估頭部常規攝影對於頭部骨折之發現，其預測顱內出血的臨床診斷價值。對於急診頭部創傷的病人，頭部常規攝影的靈敏度只有54%，特異性92%，陽性預測值70%，陰性預測值85%，準確度82%。頭部常規攝影對於頭部外傷病人的顱內狀況的靈敏度只有五成，故其臨床診斷之價值不高。

關鍵字

頭部創傷 ； 頭部常規攝影 ； 電腦斷層攝影

並列摘要

Head injury is one of the most common events in emergency room(ER) for trauma patient. Head injury often accompanies with the risk of intracranial hemorrhage. Skull radiography is usually a basic screening imaging modality clinically. However, skull radiography was reported to be unnecessary for evaluation of head injury in the literature. Therefore, the purpose of our study was to evaluate the value of skull radiography for the patients with head injury in our hospital. From April to November 2003,100 patients who received both skull radiography and computed tomography (CT) were enrolled in this study. We evaluated the clinical value of skull radiography in correlation with intracranial hemorrhage by the finding of skull fracture. The results showed: the sensitivity of skull radiography is 54%, specificity 92%, positive predictive value 70%, negative predictive value 85% and the accuracy 82%. In conclusion, the skull radiography has little value in clinical assessment of the intracranial condition of patient with head injury due to its low sensitivity.

並列關鍵字

head injury ； skull radiography ； CT