锐器穿通性膈肌破裂的CT征象  

CT Findings of Penetrating Diaphragmatic Rupture

作　　者：杜绪仓 黄英荷 张翔鸣 高飞 祁朝阳 鲍俊初 

机构地区：[1]深圳市松岗人民医院放射科,广东深圳518105

出　　处：《海南医学》2013年第2期210-212,共3页Hainan Medical Journal

摘　　要：目的探讨螺旋CT及多层螺旋CT对锐器穿通性膈肌破裂的诊断价值。方法对2007年4月至2012年2月在我院住院,并经临床及手术证实的22例急性创伤性锐器穿通伤膈肌破裂患者的CT图像进行回顾性分析。其中右侧膈肌破裂7例,左侧膈肌破裂15例,未见双侧膈肌同时破裂病例。结果锐器穿通性膈肌破裂的征象包括膈肌不连续(裂口征)9例,弹道征8例,膈肌增厚8例,腹腔脏器疝入胸腔7例,狭颈征2例,内脏坠落征6例,肋膈窦闭塞征3例,同时出现的胸腹腔积血7例,无上述阳性CT征象3例。结论穿通性膈肌破裂CT征象较隐匿,直接征象与间接征象相结合,是提高膈肌破裂CT诊断率的前提。Objective To assess the value of helical CT and multi-slice helical CT in the diagnosis of pene- trating traumatic diaphragmatic rupture. Methods Twenty-two CT findings of penetrating diaphragmatic rupture., which were confirmed by clinical and operation from April 2007 to February 2012, were reviewed retrospectively. Of which 7 cases of right hemidiaphragmatic rupture, 15 cases of left hemidiaphragmatic rupture, without bilateral dia- phragmatic rupture.Results Penetrating signs of diaphragmatic rupture including diaphragmatic discontinuity （9 cas- es）, trajectry sign （8 cases）, diaphragmatic thickening （8 cases）, intrathoracic herniation of abdominal viscera （7 case）, collar sign （2 cases）, dependent viscera sign（6 cases）, sinus cut-off sign （3 eases）, both hemothorax and hemoperitone- um （7 cases）, no positive CT signs （3 cases）. Conclusion The CT features of penetrating diaphragmatic rupture are occult. Combined with direct signs and indirect signs, the diagnostic rate can be improved.

关 键 词：膈肌破裂 穿通伤 断层摄影术 X线计算机 

分 类 号：R656[医药卫生—外科学]