对比剂外逸在急腹痛及腹部闭合性创伤CT诊断中的价值  

CT Contrast Medium Active Extravasation in the Diagnosis of Acute Abdominal Pain and Blunt Trauma

作　　者：陈杰[1] 胡春洪[2] 邢伟[1] 邱建国[1] 陈明[1] 张永成[1] 

机构地区：[1]江苏省常州市第一人民医院放射科,213003 [2]江苏省苏州大学附属第一医院影像中心,215006

出　　处：《临床放射学杂志》2010年第9期1208-1210,共3页Journal of Clinical Radiology

摘　　要：目的回顾性分析15例对比剂外逸患者的多层螺旋CT表现,评价其诊断价值。资料与方法 15例患者包括腹主动脉动脉瘤破裂2例、闭合性腹部外伤12例及腹壁自发性血肿1例,均行CT平扫及增强扫描。所有病例均经外科手术、数字减影血管造影(DSA)或随访证实。观察所有病例对比剂外逸的CT特征,并对动脉期及门静脉期图像质量进行统计学分析。结果 15例均可见对比剂外逸。动脉期及门静脉期外逸对比剂CT值分别为(175.5±20.7)HU和(157.8±21.6)HU。14例为单发,1例为多发;5例呈喷射状,10例为血肿内局灶性高密度灶,其中2例延迟后血肿密度部分升高。动脉期及门静脉期分辨外逸对比剂及原发病变有明显差异,门静脉期图像优于动脉期。结论多层螺旋CT是评价活动性血管外对比剂逸出的有效方法。Objective The aim of this study was to analyze CT imaging features of CT contrast medium active extravasation in acute abdominal pain and blunt trauma.Materials and Methods Fifteen patients,including two cases of abdominal aortic aneurysm rupture,one cases of spontaneous abdominal wall hematoma and twelve cases of blunt abdominal trauma,underwent plain and contrast CT examinations.All cases were confirmed by surgery,DSA,or follow-up.CT features of contrast medium active extravasation were observed.Results CT attenuation values of contrast medium extravasation were 175.5±20.7HU in arterial phase and 157.8±21.6HU in portal phase.Fourteen cases had solitary,and one case had multiple extravasation site.Five cases were jet-like extravasation.Ten cases showed focal high-density within the hematomas,in which two cases revealed diffuse density in a hematoma on delayed scan.The contrast medium extravasation and primary lesions had obviously different features in arterial and portal venous phase.Conclusion Multi-slice CT can evaluate acute contrast medium extravasation effectively.

关 键 词：血管外逸出 活动性 闭合性创伤 腹部 体层摄影术 X线计算机 

分 类 号：R816.5[医药卫生—放射医学]