大网膜钝性创伤的MSCT表现  

The MSCT findings of greater omentum blunt trauma

作　　者：文峰[1] 赵振国[1] 顾强[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》2014年第10期1661-1664,共4页Journal of Practical Radiology

基　　金：上海浦东新区卫生系统领先人才培养基金（PWR12010-02）;上海浦东新区人民医院重点学科群基金（PRxkql2013-03）.

摘　　要：目的：通过对大网膜钝性创伤（GOBT）的多层螺旋 CT（MSCT）表现与手术和（或）病理对照分析,提高对 GOBT 的MSCT诊断水平。方法回顾性分析经手术和（或）病理证实的51例 GOBT患者的 MSCT表现。所有患者均行 MSCT横断平扫,分别就平扫、平扫联合后处理图像2种方法对是否大网膜创伤进行双盲读片,2种方法对大网膜损伤的检出率运用配对四格表Fisher确切概率法χ2检验。结果51例 GOBT 位于空回肠前方27例、上腹部18例,左下腹区3例,右下腹区3例。GOBT 的MSCT主要表现为大网膜污浊样条索影、大网膜血肿影、腹腔积血影,其检出率分别为80.3%、68.6%和90.2%；本组综合运用MSCT征象对大网膜损伤的正确诊断率达94.1%（48/51）。2种方法对 GOBT的检出率有显著性差异（P=0.04）。MSCT横断平扫联合后处理图像明显提高对 GOBT的检出率。结论 GOBT的 MSCT表现具有一定特点,根据 MSCT 平扫联合后处理图像可对 GOBT做出较为准确的诊断。Objective To improve the accuracy of diagnosis of the greater omentum blunt trauma（GOBT）by analyzing the MSCT findings and pathological features.Methods The MSCT appearances of 5 1 cases of GOBT with operation and （or）pathological con-firmed were analyzed retrospectively.All patients were underwent MSCT plain scan in whole abdomen.Two experienced radiolo-gists blinded to the clinical diagnosis,reached a diagnosis from the MSCT findings by two ways of plain and plain joint post-process-ing MSCT images.The detection rates of GOBT were compared by two-related-samples Fisher exact probability chi-square test.Re-sults Fifty-one cases of GOBT were distributed over the intestine,in the superior abdominal cavity,the left and the right abdominal cavity,those cases were 27,18,3 and 3 respectively.The MSCT findings of GOBT mainly consist of greater omentum（GO）streak-ing,GO hematoma and fluid around GO.Those detectable rates were 80.3%,68.6%and 90.2 % respectively.The accuracy in di-agnosis of GOBT with MSCT was 94.1%（48/51）in our study.The detection rate of GOBT by two ways was significant （P=0.04）.The detection rate of GOBT was increased obviously by the way of plain joint post-processing MSCT images.Conclusion MSCT manifestations of GOBT has some characteristics.A more accurate diagnosis of GOBT could be made according to the MSCT findings by plain joint post-processing MSCT images.

关 键 词：大网膜 创伤 计算机体层成像 病理学 

分 类 号：R656[医药卫生—外科学] R446.8[医药卫生—临床医学]