急性肝破裂伤的CT和MRI诊断  

CT and MRI diagnosis of acute hepatic injury

作　　者：王仁贵[1,2,3] 蒲永林 高玉洁[1,2,3] 

机构地区：[1]北京医科大学第一临床医学院医学影像科 [2]日本佐贺县伊万里市山元外科病院 [3]北京医科大学第二临床医学院医学影像科

出　　处：《中华放射学杂志》1997年第4期255-258,共4页Chinese Journal of Radiology

摘　　要：目的：回顾性总结１０例急性肝破裂伤的ＣＴ和ＭＲＩ表现特征。材料与方法：１０例患者于受伤后２４小时内行ＣＴ或ＭＲＩ检查，肝破裂损伤根据受累范围分为轻、中、重三度。结果：外伤后２４小时内，３３．３％和２８．６％的肝破裂伤在ＣＴ平扫和ＭＲＩＴ１加权像上呈等密度和等信号，所有病变在Ｔ２加权像上均呈边界清楚的明显高信号。如果以Ｔ２加权像作为标准对照，Ｔ１加权像和ＣＴ平扫判断急性肝破裂伤损伤程度的符合率分别为５７．１％和５５．６％。５５．６％（４／７）的深破裂伤在术后１～３周内合并迟发性并发症。结论：Ｔ２加权像可准确判断急性肝破裂伤的损伤程度和类型，并与术中所见一致。对深破裂伤患者，有必要在伤后１月内行ＭＲＩ和ＣＴ随访，以明确合并症的诊断。Purpose:To evaluate and compare MR and CT in diagnosis of acute traumatic hepatic laceration. Materials and methods: Ten patients with acute hepatic rupture underwent CT scan and/or MRI in the first 24 hours after injury. The injury was graded as mild (<25% of one lobe), moderate(25%～50% of one lobe), or severe (>50% of one lobe). Results: In the first 24 hours after injury, 33.3% (3/9) and 28.6% (2/7) of the hepatic injury demonstrated isodensity and isointensity on plain CT scan and T 1 weighted images. All the lesions (100%) were clearly identified as marked hyperintensity on T 2 weighted images. On T 2 WI, T 1 WI and noncontrast CT, 100%, 57.1% and 55.6% of the acute hepatic injuries could be graded respectively. Delayed complications occurred in four patients with deep hepatic injury about 1 to 3 weeks after injury. Conclusion: T 2 weighted MR imaging is more sensitive and useful for detection of the type and severity of acute hepatic rupture. Follow up MRI or CT within the first few weeks after injury is needed in patients with deep hepatic injury for detection of delayed complications.

关 键 词：肝破裂 CT NMR 成像 

分 类 号：R657.320.4[医药卫生—外科学]