多层螺旋CT平扫对急性腹部创伤的诊断价值  

Evaluation of unenhanced multislice CT to emergency abdominal trauma

作　　者：刘军[1] 赵建农[1] 

机构地区：[1]重庆医科大学附属第二医院放射科

出　　处：《医学影像学杂志》2008年第7期807-810,共4页Journal of Medical Imaging

摘　　要：目的:进一步认识16层螺旋CT平扫在急性腹部创伤中的诊断价值。方法:990例急性腹部创伤患者,在未口服对比剂情况下行16层螺旋CT平扫,分析其CT影像表现。CT扫描后123例行剖腹术,18例经介入治疗,665例经过1次以上CT随访。把CT初诊结果与手术及随访结果进行比较,观察CT平扫发现急性腹部创伤的敏感性、特异性。结果:990例腹部创伤患者中,首诊阴性病例703例,阳性病例287例,其中实质性脏器损伤238例,空腔脏器损伤7例,实质性脏器损伤合并空腔脏器损伤19例,23例仅见腹腔积液。与手术及随访结果比较,发现实质脏器损伤的假阳性9例,假阴性2例;空腔脏器损伤的假阳性3例,假阴性5例。实质性脏器损伤的敏感性为99.2%,特异性为98.8%;空腔脏器损伤的敏感性为82.1%,特异性99.7%。结论:多层螺旋CT对急性腹部创伤有较高诊断价值,对实质性脏器损伤的发现具有很高的敏感性、特异性,对于空腔脏器损伤诊断的敏感性相对较低。Objective：To recognize the diagnostic value of emergency unenhanced CT without oral contrast material in the diagnosis of abdominal trauma.Methods：990 patients with abdomen symptom underwent plain scan using 16-row spiral CT without oral contrast material,their CT pictures were noted.Among these,123 cases underwent ventrotomy,18 cases underwent interventional therapy,and 665 cases underwent CT follow-up visit.The initial CT results were compared with the operative and follow-up outcome.Results：In 990 patients with abdomen symptom,there were 703 negative cases and 287 positive cases consisted of 238 solid visceral injuries and 7 hollow visceral injuries and 19 complicated injuries.Compared with operative and follow-up outcome,there were 2 falsenegative and 9 false-positive in solid visceral injury and the sensitivity and specificity were 99.2% and 98.8%,respectively.There were 5 false-negative and 3 false-positive in hollow visceral injury and the sensitivity and specificity were 82.1% and 99.7%,respectively.Conclusion：16-row spiral CT has the high diagnostic value to emergency abdomen injury,especially for solid visceral injury.It can make us diagnose solid visceral injury quickly and accurately.The sensibility and specificity to solid visceral injury is higher than that to hollow visceral injury.

关 键 词：腹部创伤 体层摄影术 X线计算机 平扫 

分 类 号：R656[医药卫生—外科学] R814.42[医药卫生—临床医学]