頸椎橫向斜位攝影於急診外傷病患之應用

The Application of Cross-table Oblique Cervical Spine Radiographs for Patients with Suspected Cervical Spine Injuries in Emergency Rooms

盧玉龍(Yu-Lung Lu) ； 陳俊傑(Chun-Chieh Chen) ； 林理涵(Li-Han Lin) ； 林松水(Song-Shei Lin)

《中華放射線技術學雜誌》 38卷1期 (2014/03) Pp. 34-38

摘要

一般而言，在急診外傷科的病患，大多為意外事故且合併多處骨折與挫傷而被送至急診做急救治療。此時，病患通常有頸圈（collar）保護著頸椎，所以頸部不能給予太大的動作，以避免二度傷害。而此時病患因無法伸展手臂，並不適合實施游泳者側位姿勢（Swimmer's Lateral Position）攝影。為改善影像判讀度及減少病患移動之危險性，本研究採用醫院內隨手可得之翻身枕及枕頭等協助病患呈現半側躺之姿勢，並調整角度至取得可供判斷影像。X光照射條件為70kVp、320mA、開啟AEC自動曝露控制（automatic exposure control，AEC），距離為180公分。結果發現，改採用頸椎橫向斜位攝影（Cross-table Oblique Cervical spine Radiographs）後，可以有效避開因兩邊肩部重疊而造成的困擾。不但可以清晰看到C1～C7，甚至到T2的椎骨也清晰可見。此方法能提高影像判讀度及減少病患移動之危險性，是檢查頸椎椎間孔、椎弓斷裂、椎體滑脫等不可多得的攝影方式。與游泳者側位姿勢攝影相較之下，其影像顯示更加清晰、更有利於臨床醫師的診斷。

關鍵字

頸椎挫傷 ； 頸椎攝影 ； 游泳者側位姿勢攝影

並列摘要

The patients with suspected cervical spine injuries in emergency rooms are mostly caused by the accidents and combined with injuries of fracture and contusion. They usually wear collars to protect the cervical spine. In order to avoid the second injuries, the patients cannot be treated with strong power. Thus, Swimmer's Lateral Position View is not appropriate to use when C7 is unable to discern. Due to the inability of stretching their arms, we take Cross-table Oblique Cervical spine Radiographs. We put a sponge cushion, which is used to help turn the patients around, between the patient's neck and back, and oblique the body at an angle of 45 degrees. Therefore, we can see a clear oblique cervical spine radiograph of C1-T1. Surgeons usually order a C-spine Lateral view to check the conditions of the patients with cervical spine injuries. If the patients are too strong, the Lateral view only shows C1-C4 instead of C5-C7, which is too blank to recognize. After the discussion with X-ray and clinical doctors, we conclude that if a Cross-table oblique view is added, a clearer quality of C1-C7 will be shown, even for a better T2 picture. This method can offer a better quality of image diagnosis than the Lateral view, and is more helpful to the clinical diagnosis.

並列關鍵字

Cervical contusion ； X-rays of the cervical spinal cord ； Swimmer's Lateral Position View