摘要
目的 比较分析腹部实质脏器 闭合性外伤超声、CT影像表现及诊断价 值。方法 以我院2014年1月至2015年12 月经手术病理证实的100例腹部实质脏器 闭合性外伤患者为研究对象,所有患者 入院时接受超声、CT检查,观察各自影 像表现,并以手术病理结果为对照,比 较超声、CT对腹部实质脏器闭合性外伤 诊断符合率。结果 手术病理证实腹部实 质脏器闭合性外伤共118个,其中多脏器 损伤28个。以手术病理结果为对照,CT 诊断脾脏损伤符合率、多脏器损伤符合 率、总符合率分别为89.28%、100.00%、 90.68%,均显著高于超声的71.43%、 85.71%、80.51%,差异有统计学意义(P <0.05)。超声诊断肝脏损伤、肾脏损伤 符合率分别为85.36%、95.24%,较CT的 90.24%、95.24%差异无统计学意义(P> 0.05)。腹部实质脏器闭合性损伤超声特 点为损伤脏器体积变大,不均匀回声; CT特点为损伤脏器体积变大,不均匀密 度影,增强扫描更明显。结论 超声与 CT在腹部肝脏及肾脏损伤诊断准确率类 似,但CT在多脏器损伤、脾脏损伤诊断 上更有优势。
Objective To compare and analyze the imaging findings of ultrasound and CT and their value in the diagnosis of abdominal solid organ closed trauma. Methods One hundred cases of patients with abdominal solid organ closed trauma confirmed by operation and pathology in our hospital between January 2014 and December 2015 were selected as the study object. All patients underwent ultrasound and CT examination on admission. Their imaging findings were observed. The results of operation and pathology were taken as the contrast to compare the coincidence rates of ultrasound and CT in the diagnosis of abdominal solid organ closed trauma. Results Operation and pathology confirmed that there were 118 closed injuries of abdominal solid organs and 28 of them were multiple organ injuries. The operative and pathological results were taken as control. The coincidence rates of CT in diagnosis of splenic injury and multiple organ injury and the total coincidence rate (89.28%, 100.00%, 90.68%) were significantly higher than those of ultrasound (71.43%, 85.71%, 80.51%) (P<0.05). The coincidence rate of ultrasound in the diagnosis of liver injury and renal injury were 85.36% and 95.24% respectively while those of CT were 90.24% and 95.24% respectively (P>0.05). The characteristics of abdominal solid organ closed trauma were enlarged volume of the injured organs and inhomogeneous echo. CT findings were enlarged volume of injured organs, inhomogeneous density shadows. After enhanced scan, it become more obvious. Conclusion The accuracy rate of ultrasound in the diagnosis of abdominal liver and kidney injuries is similar to CT but CT is superior in the diagnosis of multiple organ injury and spleen injury.
【关键词】腹部实质脏器闭合性外伤; 超声;CT;影像表现
【中图分类号】R445.1;R445.3;R641
【文献标识码】A
【DOI】 10.3969/j.issn.1672- 5131.2016.07.034
前言
腹部闭合性外伤具有发病急、病情进展快、预后较差等特点, 临床常伴实质脏器损伤或空腔脏器损伤,是导致患者死亡的主要原 因之一[1]。目前临床降低腹部实质脏器闭合性外伤病死率的关键在于 早期有效干预,而早期干预与早期正确诊断密切相关[2]。由于腹部闭 合性外伤入院后病情复杂,可能对脏器损伤体征掩盖,易漏诊;腹腔 穿刺对腹部闭合性损伤具体部位、损伤程度难以明确,且对轻度腹部 脏器损伤可能漏诊[3]。超声、CT为腹部闭合性损伤常见影像学方法, 在腹部脏器损伤诊断中各有优缺点。基于此,本研究对我院2014年1 月~2015年12月收治的腹部实质脏器闭合性外伤患者超声、CT影像学 资料进行回顾性分析,比较超声、CT对腹部脏器损伤的诊断价值,为 临床疾病诊治提供重要影像学依据。现报告如下。
中国CT和MRI杂志
第14卷, 第 7 期
2016年07月
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