The Applied Research Of Direct Digitalradiography(DR) In The Imaging Diagnosis Ofindustrial Skeletal Fluorosis

Objective:Using direct digital X-ray photography (direct digital radiography, DR) of the image edge screening for industrial skeletal fluorosis, summarized industrial skeletal fluorosis, especially early cases in DR image characteristics, industrial skeletal fluorosis in order to regulate the inspection method and criteria for diagnosis of DR under provides the basis.Materials and Method:Choose touch the fluorine is engaged in the work more than5years, urinary fluorine check above baotou normal urinary fluoride level of observation object is a total of314people. Touch the fluorine according to time length is divided into A, B, C three groups, the length of5to10years of observation object set as group A,107; The length of10-15years of observation object set as group B,125; Length of service more than15years of observation object set as group C,82. For every man is a pelvis, right foot radius and tibiofibula positive side, the side of lumbar is DR photography. All images are from three or more persons with relevant professional knowledge of high qualification doctor diagnosis for collective confirmed, follow the standards of country X ray diagnosis of skeletal fluorosis (WS192-1999) and diagnostic criteria of industrial fluorosis (GBZ5-2002) of the image data are summarized and the installment, and with the national industrial fluorine disease imaging diagnostic criteria (GBZ5-2002) were compared. Results:All314subjects, diagnosed with industrial skeletal fluorosis for249people, accounting for79.30%of the total observed object. Including107people in the group A, in accordance with skeletal fluorosis Ⅰ period (early) image changer34people, in line with the phase Ⅱ image changer8people, the remaining65are negative, positive rate39.25%; Group B,125, in line with skeletal fluorosis Ⅰ period (early) image change of71people, the rest of the54per capita in stage Ⅱ image changes, positive rate100%; Group C,82, in line with skeletal fluorosis Ⅰ stage Ⅰ image the change of61people, the rest21per capita in stage III image changes, positive rate was100%.Main show is in stage I of skeletal fluorosis in DR image:enlargement of trabecular bone is added thick, show the "sand" or bone spot or "gauze" change; Ulnar radial/tibiofibula limited ossification, interosseous membrane partial tendon ligament calcification, and joint mild degenerative change; Ⅱ period of skeletal fluorosis mainly:the bone density increased significantly, the trabecular bone obvious enlargement of sparse, coarse grain shaped or blanket change, ulnar radial or tibiofibula visible hillock shape/wavy ossification interosseous membrane; Knee flex tendons ossify, joint degeneration. Or other parts of tendon or ligament apparent ossification; Ⅲ period mainly for trabecular bone of skeletal fluorosis widely rough or fine, severe cases show "marble pattern" change or ivory sample hardening; Ossification wide and interosseous membrane significantly, elbow flexor tendons ossify, medullary cavity narrow joint degeneration, other parts of the tendon or ligament ossification.Conclusion:1. Industrial change in phase Ⅰ in DR image of skeletal fluorosis, except GBZ5-2002standard in increased bone density, bone trabecular enlargement, add thick, crossed a "gauze" performance; Feet, radial or tibia, fibula with clear interosseous membrane calcification or ossification performance can also be observed:(1) the sand samples trabecular bone and/or bone formation. Atypical interosseous membrane thickening, typical ossification interosseous membrane can be characterized by germ to break ground.(3) the place such as elbow, pelvis and lumbar, tendons, ligaments mild ossification.2. Industrial change in phase Ⅱ in DR image of skeletal fluorosis, except GBZ5-2002standard in bone density increased significantly, the trabecular bone enlargement, obviously is "sacks of grain appearance" performance; Change is more obvious and broad bone weeks can also be observed that:(1) the trabecular bone is "broken carpet sample". Diction ossification interosseous membrane more apparent, in the "hill" or "wave".(3) tendon, ligament ossification, may be accompanied by mild joint degeneration, with elbow is especially typical.3. Industrial change in phase Ⅲ in DR image of skeletal fluorosis, except GBZ5-2002standard in significantly increased bone density, bone trabecular blurred as the "marble"; Long bone cortical thickening, and narrow medullary cavity. Bone weeks change more evident and wide, between the vertebral bodies can have a form can also be observed outside the bone trabecular bone bridge is the "ground glass". Diction ossification wide interosseous membrane appeared, the typical show "melting wax sample" or "ice".(3) elbow and other parts of the flexor tendon or tendon or ligament ossification, joints obvious degeneration.4. GBZ5-2002standard of skeletal fluorosis in X-ray parts are included in the lumbar positive side, this topic that application of DR diagnosis industrial skeletal fluorosis, lumbar positive side of the bone trabecular structure effect is poor.GBZ5-2002standards in general X-ray plain film paper summarizes image performance as the foundation, from one period to the image of skeletal fluorosis signs description is less, the concept is not clear, image signs is not comprehensive, operability is not strong. Now DR equipment has been widely used in medical treatment and medical institutions at all levels, Suggestions for industrial DR imaging manifestations and diagnostic criteria of skeletal fluorosis revision, carries on the elaboration, added.