腹腔空腔脏器损伤的多层螺旋CT表现  

Spiral CT Diagnosis of Abdominal Hollow Viscera trauma

作　　者：彭德昌[1] 龚洪翰[1] 张宁[1] 夏国金[1] 曾献军[1] 肖香佐[1] 

机构地区：[1]南昌大学第一附属医院,南昌330006

出　　处：《临床放射学杂志》2014年第3期385-387,共3页Journal of Clinical Radiology

摘　　要：目的探讨腹腔空腔脏器损伤的CT表现。方法回顾性分析经手术证实的腹腔空腔脏器损伤患者25例多层螺旋CT平扫表现。结果 25例腹腔空腔脏器损伤中,1例胃壁连续性中断。2例局限性小肠壁肿胀增厚。2例肠壁血肿形成。15例腹腔游离气体,气体的形态为新月形或为圆形大小不一的气泡影;气体量从极少到多量,主要位于膈肌下或前腹壁下或肝门。肠系膜内血肿或肠系膜肿胀脂肪密度增高24例。腹腔内积液25例,从少到中等量,多位于肝脾周缘、肝肾间隙、膀胱直肠窝或子宫直肠窝。其他合并症包括腹前壁肿胀、腹直肌断裂、腰椎粉碎性骨折。结论根据肠壁断裂、肠壁血肿及肠壁肿胀等CT直接征象表现,结合腹腔积气、腹腔积液及肠系膜损伤等CT间接征象表现,可以快速、准确、无创伤地作出正确的诊断。Objective To investigate CT manifestation of abdominal hollow viscera trauma. Methods 25 cases of abdominal hollow viscera trauma proved by surgery were retrospectively reviewed. Results Among 25 patients, 1 patient was found the stomach wall discontinuous, 2 were found localized swelling and thickening intestinal wall and 2 had intestinal wall hematoma. Free gas was seen in the peritoneal cavity in 15 cases, with crescent shaped hypodensity or round bubble in different size. The amount of gas from less to more, mainly located under diaphragm, inferior anterior abdominal wall and hilus hepatis. 24 patients were found mesenteric hematoma or mesenteric swelling and increase in density. All of the patients had less to moderate fluid in peritoneal cacity, most of which was around live and spleen, recess in live and kidney or retrovesical pouch/Doulags′s space. Other complications included anterior abdominal wall swelling, rectus abdominis ruptured and lumbar comminuted fracture. Conclusion When the direct signs of intestinal wall discontinuous, intestinal wall hematoma, the intestinal wall swelling and indirect signs of pneumoperitoneum, ascites and mesenteric injury are found, abdominal hollow viscera trauma can be accurately, rapidly and noninvasively diagnosed .

关 键 词：空腔脏器 损伤 体层摄影术 X线计算机 

分 类 号：R816.5[医药卫生—放射医学] R656[医药卫生—临床医学]