CT征象诊断创伤性膈肌破裂  

CT features in diagnosis of traumatic diaphragmatic rupture

作　　者：张正平[1] 牛建栋[1] 侯晓婧 王志涛[1] 田兴仓[1] 孟淑萍[1] 王志军[1] 

机构地区：[1]宁夏医科大学总医院放射科,宁夏银川750004 [2]宁夏回族自治区第三人民医院超声科,宁夏银川750011

出　　处：《中国医学影像技术》2018年第2期246-249,共4页Chinese Journal of Medical Imaging Technology

摘　　要：目的探讨CT征象诊断创伤性膈肌破裂的价值。方法回顾性分析256例可疑创伤性膈肌破裂的胸腹部损伤患者的资料,经手术证实膈肌破裂128例,膈肌无破裂128例。对所有患者术前均行CT检查,观察CT征象包括膈肌连续性中断或膈肌部分未显示、领口征、腹腔内容物进入胸腔、腹部内脏依靠、膈肌移位、膈肌增厚,计算各征象诊断创伤性膈肌破裂的敏感度和特异度。结果膈肌连续性中断或部分未显示诊断创伤性膈肌破裂的敏感度和特异度分别为75.00%(96/128)和93.75%(120/128),领口征为84.37%(108/128)和98.43%(126/128),腹腔内容物进入胸腔为78.13%(100/128)和98.43%(126/128),腹部内脏依靠为76.56%(98/128)和99.21%(127/128),膈肌移位为54.68%(70/128)和93.75%(120/128),膈肌增厚为46.87%(60/128)和84.38%(108/128)。MSCT征象综合诊断的敏感度为92.18%(118/128),特异度为100%(128/128)。结论 MSCT征象对创伤性膈肌破裂有较高的诊断价值。Objective To explore value of CT features in diagnosis of traumatic diaphragmatic rupture. Methods A retrospective analysis was performed on totally 256 patients with suspected traumatic diaphragmatic rupture, among them 128 were confirmed after surgery. All patients underwent CT scan before surgery. The prevalence of CT findings were recorded, including diaphragm discontinuity or segmental non-recognition of diaphragm, ＂ collar＂ sign, ＂ intrathoracic herniation of abdominal contents＂ sign, ＂ dependent viscera＂ sign, ＂ dangling diaphragm＂ sign and ＂ thickness of the diaphragm＂ sign. The sensitivity and specificity of each sign were calculated. Results The sensitivity of diaphragm discontinuity or segmental non-recognition of diaphragm, ＂collar＂ sign, ＂intrathoracic herniation of abdominal contents＂ sign, ＂dependent lscera sign, ＂dangling diaphragm＂ sign and ＂thickness of the diaphragm＂ sign of diaphragmatic rupture was 75. 00% （96/128）, 84.37% （108/128）, 78,13% （100/128）, 76.56% （98/128）, 54.68% （70/128） and 46.87% （60/128）, respectively. The specificity was 93.75% （120/128）, 98. 43% （126/128）, 98. 43% （126/128）, 99. 21% （127/128）, 93. 75% （120/128） and 84. 38% （108/128）, respectively. The sensitivity and specificity of overall MSCT signs was 92.18% and 100%, respectively. Conclusion CT features have high value in diagnosis of traumatic diaphragmatic rupture.

关 键 词：嘛 体层摄影术 X线计算机 胸部 腹部 创伤和损伤 

分 类 号：R641[医药卫生—外科学] R814.42[医药卫生—临床医学]