CT平扫诊断钝性伤脾破裂

探讨CT平扫诊断钝性伤脾破裂的标准。材料与方法回顾性分析60例钝性脾破裂患者(其中55例手术，5例临床证实)的CT片及临床资料，放射科医生双盲读片分析。结果60例患者有明确的外伤史，经CT平扫发现脾实质密度不均匀(包括脾实质血肿、脾包膜下血肿、脾撕裂等)、脾包膜中断或呈“葱皮”样改变共39例(65％)，“哨兵血块征”54例(90％)，腹腔积血46例(76.7％)，脾肿大34例(56.7％)，脾附近软组织挫伤、骨骼骨折17例(28.3％)。结论CT平扫诊断钝性脾破裂的直接征象是脾包膜中断或呈“葱皮”样改变，其余皆为间接征象。

Blunt Splenic Rupture: Conventional CT Diagnostic Criteria

Purpose: To study the conventional CT diagnostic criteria of blunt splenic rupture. Materials and methods: The CT and clinical dataof 60 patients of blunt splenic rupture confirmed by operation or clinical diagnosis were retrospectively reviewed and analyzed. The CT appearenceswere independently reviewed in a double blind method by radiologists. Results: Of 60 cases of blunt splenic rupture, CT demonstrated heterogeneoussplenic parenchyma (include parenchymal hematcma, subcapsular hematoma and splenic laceration), capsular interrupted or “onionskin” in 39 cases(65%), sentinel clot sign in 54(90% ), hemoperitoneum in 46(76.7% ), spleen enlarged in 34(56.7% ), soft tissue injure and skeleton fracturessurrounded spleen in 17 (28.3 % ). Conclusion: The diagnostic criteria of conventional CT in blunt splenic rupture is: (1) blunt injure, (2)hetero-geneous splenic parenchyma, (3)sentinel clot sign, (4) hemoperitoneun, (5) spleen enlarged and, (6)soft tissue injure and skeleton fractures sur-rounded spleen. CT is a useful and accurate imaging modality in the evaluation of blunt splenic rupture.