MSCT在钝性肾创伤中的临床应用价值  

Clinical value of MSCT in blunt renal trauma

作　　者：文峰[1] 赵振国[1] 顾强[1] 唐小彬[1] 

机构地区：[1]上海市浦东新区人民医院放射科,上海201299

出　　处：《实用放射学杂志》2013年第3期392-395,共4页Journal of Practical Radiology

基　　金：浦东新区卫生系统领先人才培养基金（PWR12010-02）.

摘　　要：目的 探讨多层螺旋CT（multi-slice spiral computed tomography，MSCT）在钝性肾创伤（ blunt renal trauma ,BRT）的临床价值。方法 回顾分析56例经临床手术病理证实的BRT患者资料，所有患者均行MSCT平扫及增强检查，分别就平扫、增强、增强联合后处理等3种方法对是否肾脏创伤进行双盲读片，并按美国创伤外科协会（AAST）肾创伤分级标准进行分级阅片。3种方法对损伤的检出率运用行乘列表的Pearsonχ2检验。MSCT平扫和增强对肾损伤的AAST分级，运用Fisher确切概率法χ2检验。结果 本组MSCT征象对BRT的阳性影像表现的检出率为51.8%（29/56）。3种方法对BRT的阳性影像检出率无显著性差异（P=0.095）。MSCT平扫与增强在BRT属Ⅳ级，卡方检验显示有显著性差异（P=0.040），其他级别的BRT 2种检查方法之间无显著性差异（P〉0.05）。结论 MSCT能对钝性肾创伤损伤做出准确诊断，增强扫描能提高BRT的AAST分级的准确性，对临床治疗方案的选择有重要价值。Objective To investigate the clinical value of multi-slice spiral computed tomography （MSCT） in the blunt renal trau ma （BRT）. Methods 56 kidneys with clinical proved BRT were retrospectively analyzed. All patients were underwent plain and enhanced MSCT scan in whole abdomen. Two experienced radiologists blinded to the clinical diagnosis, reached a consensus diagnosis from the MSCT findings by three ways of plain ,enhanced and enhance connected the post-processing MSCT images. The detection rate of BRT was compared with others by using Pearson chi-square test. The grade of BRT according to the American Association for the Surgery of Trauma （AAST） renal injury scale was judged by radiologists. The BRT AAST grade with plain and enhanced MSCT was analyzed by Fisher probabilities chi-square test. Results The diagnostic detection rate of BRT with MSCT was 51.8% （29/56） in our study. The detection rate of BRT by three ways was no significant （P=0. 095）. The chi-square test shows that there was significant difference only in the BRT AAST grade IV with plain and enhanced MSCT （P=0. 040）. Conclusion The BRT can be accurate diagnosed by MSCT examination. Enhanced MSCT can improve the accuracy of the BRT AAST grade. It is valuable for clinical treatment scheme selection.

关 键 词：肾脏 创伤 计算机体层成像 病理学 

分 类 号：R692[医药卫生—泌尿科学] R814.42[医药卫生—外科学]