64层螺旋CT在纵隔血肿诊断中的价值  

Applied value of 64-slice spiral CT in the diagnosis of mediastinal hematoma

作　　者：武军 何美卿[2] 孙万兴 

机构地区：[1]山西省汾阳医院影像科CT室,山西汾阳032200 [2]山西医科大学汾阳学院图书馆,山西汾阳032200

出　　处：《实用医学影像杂志》2010年第6期359-360,共2页Journal of Practical Medical Imaging

摘　　要：目的评价64层螺旋CT在纵隔血肿合并其他脏器损伤诊断中的应用价值。方法回顾性分析经临床与手术证实的11例纵隔血肿患者的完整CT资料。结果前纵隔血肿5例,中纵隔血肿4例,后纵隔血肿2例;弥漫性血肿8例,局限性血肿3例。CT平扫发现纵隔血肿合并气胸、肋骨骨折等合并征4例,而螺旋CT多平面重建(multiplanar reconstruction,MPR)发现气胸、肋骨骨折及胸骨体骨折、颅脑外伤等7例。结论纵隔内心脏、大血管的损伤常导致弥漫性血肿,而小血管的损伤常导致纵隔内血肿呈局限性。螺旋CT扫描尤其多平面重建不仅能显示血肿的直接征象,而且还能同时发现伴发的其他损伤。因此,能为临床及时确诊和正确治疗提供可靠信息。Objective To evaluate the applied value of 64-slice spiral CT for diagnosing mediastinal hematomas and their associated injuries.Methods Complete CT data of 11 patients with clinically and surgically proved mediastinal hematoma were analyzed retrospectively.Results Among 11 cases,anterior-mediastinal hematomas were found in 5 cases,middle-mediastinal hematomas in 4 cases,and posterior-mediastinal hematomas in 2 cases;diffuse hematomas in 8 cases and localized hematomas in 3 cases.Plain CT scans showed the mediastinal hematomas associated with pneumothorax and costal fracture in 4 cases,while multiplanar reconstruction（MPR）showed the mediastinal hematomas associated with pneumothorax,costal fracture,thoracic body fracture,and craniocerebral trauma in 7 cases.Conclusion Cardiac and large vascular injuries in the mediastinum frequently resulted in the diffuse hematoma,while small vascular injuries mostly cause the localized hematoma.Spiral CT scan,especially MPR not only could show the direct signs of mediastinal hematoma but could show other associated injuries,so that it can provide the reliable information for timely definite diagnosis and correct treatment.

关 键 词：纵隔 血肿 64排螺旋CT 多平面重建 

分 类 号：R816.4[医药卫生—放射医学]