闭合性肠和系膜损伤螺旋CT诊断的能力和限度  

Blunt bowel and mesenteric injury: diagnostic capabilities and limitations of helical CT

作　　者：欧继华[1] 傅长根[2] 马跃虎 方玉祥 

机构地区：[1]淮安市妇幼保健院放射科,江苏淮安223002 [2]南京市鼓楼医院放射科,江苏南京210008 [3]上海梅山医院放射科,江苏南京210039

出　　处：《徐州医学院学报》2010年第10期691-693,共3页Acta Academiae Medicinae Xuzhou

摘　　要：目的探讨螺旋CT对闭合性肠和系膜损伤(BMI)的诊断能力和限度。方法搜集39例经临床手术证实的腹部闭合伤病例资料,由3位放射科诊断医师在不知手术结果的情况下回顾分析螺旋CT图像,并对BMI进行评价,分为无损伤、轻微损伤(不需立即手术治疗)、严重损伤(需要立即手术治疗)。螺旋CT评价结果与手术结果进行对照。结果手术证实BMI 21例,螺旋CT诊断的准确度87.2%(34/39),敏感性90.5%(19/21),特异性83.3%(15/18),阳性预测值86.4%(19/22),阴性预测值88.2%(15/17)。螺旋CT正确鉴别轻微和严重损伤14例(66.7%)。结论螺旋CT对BMI诊断敏感,但螺旋CT还不能准确评价BMI的严重程度。Objective To investigate the diagnostic performance and limitations of helical CT images of blunt bowel and mesenteric injury（BMI）.Methods The CT findings of 39 patients surgically confirmed with blunt abdominal trauma were retrospectively assessed by three CT diagnostic physicians in consensus,who were uninformed of the surgical results.The CT findings of BMI were graded as unimpaired,minor injury（no immediate surgery required） and severe injury（urgent surgery required） groups.The results of helical CT assessment and surgery were compared.Results 21 patients were confirmed with BMI at laparotomy,and helical CT performance had accuracy of 87.2%（34/39）,sensitivity of 90.5%（19/21）,specificity 83.3%（15/18）,positive predictive value of 86.4%（19/22） and negative predictive value of 88.2%（15/17）.Helical CT correctly differentiated minor from major BMI in 14 of 21 cases（66.7%）.Conclusion Helical CT is sensitive in the identification of BMI following blunt abdominal trauma,but helical CT is not highly accurate in predicting the severity of injury.

关 键 词：肠和系膜损伤 体层摄影术 X线计算机 

分 类 号：R814.42[医药卫生—影像医学与核医学]