钝性肝脾肾损伤的CT平扫与增强扫描比较  

Comparative study of plain and contrast-enhanced CT for detecting blunt trauma of liver,spleen,and kidney

作　　者：张雅丽[1] 司建荣[1] 姜兆候[1] 

机构地区：[1]广东省佛山市南海中医院放射科,广东佛山528200

出　　处：《医学影像学杂志》2006年第2期153-156,共4页Journal of Medical Imaging

摘　　要：目的:比较CT平扫与增强扫描对肝脾肾钝性损伤的诊断能力。方法:回顾性分析临床疑似钝性肝脾肾损伤,并经手术和临床观察证实的CT平扫和增强扫描的患者84例。结果:平扫确定的损伤:肝12例,脾25例,肾5例;平扫可疑损伤:肝22例,脾15例,肾5例。增强确定的损伤:肝32例,脾40例,肾12例(全肾梗塞1例,局限性梗塞3例);对比剂外溢(活动性出血)3例;无可疑损伤。平扫无异常而增强确定有损伤:肝10例,脾5例,肾2例。增强显示的损伤灶比平扫范围明显大、病灶多、界限清楚。结论:CT增强扫描显示肝脾肾损伤明显优于平扫,延时扫描有助于发现活动性出血,应常规增强扫描。Objective： To determine which one between plain and contrast-enhanced CT was better for detecting injuries d liver, spleen and kidney after blunt abdominal trauma.Methods： A retrospective review of plain and contrast-enhanced CT films was performed for 84. patients,whose liver,spleen and kidney were suspected of injuries by the clinical and other examinations.Results：On plain CT, injuries of 12 livers, 25 spleens and 5 kidneys were confirmed, and injuries of 22 livers, 15 spleens and 5 kidneys were suspected. On contrast-enhanced CT, contrast material extravasation （or active blecding） 3 case,liver injruy 32 cases, splenic injury 40 cases and renal injury 12 cases （including global infarction of kidney 1 case and local renal infarction 3 cases） were confinmed. The injury feci found were more, lager, and more distinct on contrast-enhanced CT than plain CT. Conclusion：Contrast-enhanced CT scans is far better than plain CT. Delayed CT scans through the injury loci is helpful to detect active blecding. Contrast-enhanced CT scans should he a routine examination.

关 键 词：损伤 肝 脾 肾 体层摄影术 X线计算机 

分 类 号：R575[医药卫生—消化系统] R814.42[医药卫生—内科学]