多层螺旋CT与彩色多普勒超声对外伤性肾上腺血肿的诊断价值比较

目的:比较多层螺旋CT(MSCT)与彩色多普勒超声(CDUS)在外伤性肾上腺血肿中的诊断价值。方法:42例外伤性肾上腺血肿患者在首诊中接受CDUS、MSCT检查,其中19名患者接受了进一步的对比剂增强MSCT检查。对两种检查方法的检出率与诊断准确率进行回顾性分析。结果:42例患者中共发生外伤性肾上腺血肿43处,其中发生单侧性血肿41例(右侧31例,左侧10例),双侧性血肿1例。首次检查中,MSCT的检出率和准确率分别为97.6%和90.2%;CDUS的检出率和准确率分别为71.4%和80.0%。MSCT对外伤性肾上腺血肿首次检查检出率较CDUS高(P<0.05),而诊断准确率无差异(P>0.05)。在接受进一步增强MSCT检查的19例患者,MSCT诊断肾上腺血肿准确率(100%)高于CDUS(78.9%)(P<0.05)。结论:虽然CDUS较MSCT更经济、快速且无辐射,但对外伤性肾上腺血肿检出率却低于MSCT;对比剂增强技术可进一步提高MSCT诊断的准确性。

Diagnostic Value of Multislice Computed Tomography and Color Doppler Ultrasonography in Patients with Traumatic Adrenal Hematoma:a Comparative Study

Objective To compare the diagnostic value of Multislice Computed Tomography(MSCT) and color doppler ultrasonography(CDUS) in patients with traumatic adrenal hematoma.Methods Total 42 patients with traumatic adrenal hematomas underwent MSCT and CDUS in initial examination,in which 19 patients accepted a further contrast-enhanced MSCT.The detective rate and diagnostic accuracy of the two methods were retrospectively analyzed.Results There were 43 adrenal hematomas in 42 traumaic patients,and the hematomas in 41 patients were observed in unilateral adrenal glands(31 cases in right side,10 cases in left side),only one patient was observed in bilateral adrenal gland.The detective rate and diagnostic accuracy of MSCT were 97.6% and 90.2%,and the detective rate and diagnostic accuracy of CDUS were 71.4% and 80.0% in initial examinations,respectively.The initial detective rate of MSCT was significantly higher than that of CDUS(P<0.05),meanwhile the diagnostic accuracy had no significant difference between two methods(P>0.05).In 19 patients performed a further contrast-enhanced MSCT,the diagnostic accuracy of MSCT for adrenal hematomas(100%) was significantly higher than of CDUS(78.9%),(P<0.05).Conclusion Although CDUS was more economic,fast and without radiation than MSCT,but the the diagnostic accuracy for adrenal hematomas was significantly lower.Furthermore,the contrast-enhanced MSCT could obviously improve the diagnostic accuracy.