CT对闭合性肾损伤的诊断

目的：探讨CT检查在闭合性肾脏损伤中的作用。方法：回顾性分析1986年-2008年21例闭合性肾脏损伤患者CT资料。结果：CT显示肾挫伤13例,未累及集合系统的轻微肾裂伤5例,肾脏深部裂伤或碎裂伤3例,未见累及肾蒂者,其中3例分别合并脾脏破裂（2例）和肝脏破裂（1例）。结论：CT是急性闭合性肾脏损伤首选的影像学检查方法,结合常规增强扫描,可做出准确诊断。     

闭合性肾损伤的CT评价

目的:探讨闭合性肾损伤的CT表现及其临床应用价值。方法:回顾性分析经临床或手术证实的54例闭合性肾损伤的临床及CT资料。结果:肾挫伤8例,肾内血肿3例,肾撕裂伤11例,肾碎裂伤2例,肾盂输尿管连接处撕裂1例,肾被膜下血肿33例,肾周血肿15例。漏诊肾盂输尿管损伤1例。结论:CT可快速、准确地判断肾损伤的程度及范围,为临床制订治疗方案提供依据。     

闭合性肾脏损伤的多层螺旋CT诊断分型探讨

目的总结闭合性肾损伤的多层螺旋CT(MSCT)征象,并评价MSCT分型的临床意义。方法 58例闭合性肾损伤患者于外伤后1 h～4 d内均经腹部常规多层螺旋CT扫描,其中32例又经对比增强CT扫描。所有患者中肾损伤的严重程度、血肿或渗出性病变的累及范围以及邻近脏器伴发性损伤,是由3位经验丰富的放射学医师协同评价的。结果根据肾损伤部位、程度和范围可将其MSCT表现分为下述5型:Ⅰ型,包膜下血肿(8例);Ⅱ型,肾实质局灶性挫伤(16例);Ⅲ型,肾实质挫裂伤伴肾周间隙血肿(19例);Ⅳ型,肾实质粉碎伤伴肾筋膜外血肿(13例);Ⅴ型,肾蒂撕裂伤(2例)。肾损伤的分级愈高,邻近脏器伴发性损伤比例愈大。结论 MSCT能清楚显示肾损伤的部位、范围、严重程度以及邻近脏器伴发性损伤,而MSCT分型能为临床选择治疗方案提供重要依据。     

急性闭合性胰腺损伤的CT诊断

目的 评价螺旋CT双期增强扫描对急性闭合性胰腺损伤的诊断价值.方法 回顾性分析21例临床资料完整的急性闭合性胰腺损伤的CT征象.结果 本组21 例中胰头损伤5例,胰体尾部损伤16例.胰挫伤或挫裂伤11 例(11/21),占52.38 %,胰内血肿6 例(6/21),占28.57 %,胰腺横断4 例(4/21),占19.05 %.增强扫描门脉期对胰腺实质的损伤灶显示达100%.均未能直接显示胰管断裂征象.结论 CT检查对急性闭合性胰腺损伤的诊断具有重要价值.     

螺旋CT增强及延时扫描在肾损伤诊断中的作用

目的探讨螺旋CT增强及延时扫描在肾损伤诊断中的价值.资料与方法对50例肾损伤患者的螺旋CT平扫、增强扫描和延迟扫描结果进行回顾性分析.结果 CT平扫,33例表现为肾轮廓不规则, 肾包膜下血肿14例,肾周血肿13例,肾挫伤16例,肾撕裂伤7例;CT增强扫描和延时扫描不仅显示了平扫所见,而且还显示了肾脏收集系统损伤导致尿外渗7例.结论螺旋CT增强及延时扫描在肾损伤中,特别是在收集系统损伤的诊断中有重要的作用.     

多层螺旋CT对腹部闭合性损伤的诊断价值

<正>腹部损伤约占所有损伤的0.4%～4.2%,常合并多脏器、多部位损伤而危及生命,其死亡率占所有损伤死亡率的10%。早期确诊腹部损伤的类别和准确定位有助于对伤者采取果断有效的处理措施、提高抢救成功率、降低死亡率、减少并发症。MSCT     

闭合性胰腺外伤的螺旋CT诊断及随访观察

胰腺是人体第二大消化腺,横位于胃后方的腹腔上部,属腹膜后位器官,由于位置偏后,损伤较少见,尤其是外伤时常伴有多脏器损伤,病情危重,缺乏胰腺损伤的特异体征,临床易于漏诊和误诊。本文收集2003年以来两家医院经手术证实的8例胰腺外伤患者的临床及CT资料,探讨螺旋CT及CT随访对闭合性胰腺外伤的临床应用价值。1资料与方法1·1一般资料收集两家医院2003年以来收治的胰腺外伤患者共8例,均经手术证实。其中男7例,女1例;年龄28~49岁,平均39·6岁。均为闭合性损伤,其中车祸伤5例,击打伤2例,重物砸伤1例。所有患者均在外伤后6 h以内进行急诊螺旋…     

胰腺及肾上腺闭合性损伤的CT诊断

目的:探讨腹部闭合性外伤所致胰腺及肾上腺损伤的CT表现特征,评价CT的应用价值。方法:回顾性分析23例经手术或随访证实的闭合性腹部外伤致胰腺及肾上腺损伤的临床与CT检查资料。结果:胰腺损伤19例,其中颈体部断裂11例,体尾交界部、胰头胰体部分断裂各3例,胰腺挫伤2例,主要表现为胰腺血肿,胰腺裂隙样或条状低密度影及外伤性胰腺炎改变。肾上腺损伤4例,均位于右侧,主要CT表现肾上腺区血肿,脂肪间隙模糊,其内可见条状高密度影。合并多脏器损伤8例。结论:CT能较准确的反映胰腺及肾上腺的损伤病理解剖改变,特别是胰腺断裂等重症患者,为临床制定治疗方案和疗效观察提供可靠的依据。     

闭合性肠及系膜损伤的螺旋CT诊断

目的探讨闭合性肠及肠系膜损伤的螺旋CT特点。方法回顾性分析总结17例经手术证实的肠及系膜损伤的CT征象。结果腹腔或肠管间积液、积血16例,腹腔游离气体6例,肠系膜渗出12例,肠系膜血肿10例,肠壁肿胀增厚、血肿12例,肠管扩张并积液11例。CT术前诊断明确16例,1例表现为阴性。结论螺旋CT对闭合性肠及肠系膜损伤的诊断具有重要价值,可作出准确术前诊断。     

肾螺旋CT平扫与增强延时扫描对肾损伤的诊断

目的探讨螺旋CT平扫与增强延时扫描对肾损伤的诊断价值。方法57例肾损伤患者外伤后30min～3d均经螺旋CT平扫,其中,23例又经增强延时扫描,回顾分析其CT表现特点。结果Ⅰ型肾挫伤（肾内血肿）25例,Ⅱ型肾包膜下血肿11例．Ⅲ型严重肾损伤（肾撕裂或肾断裂）15例,Ⅳ型肾例血肿6例。23例肾损伤CT增强扫描和延时扫描不仅显示了平扫所见,而且,还硅示了肾集合系统损伤导致尿外液渗9例。结论肾螺旋CT平扫与增强延时扫描能显示肾损伤的的部位、范围、类型以及合并其他的损伤,并能指导怖床治疗。     

肾损伤的CT诊断

目的：分析肾损伤的ＣＴ表现特征,探讨其诊断价值。方法：对我院１９９４年５月￣１９９７年６月２０例肾损伤的ＣＴ表现进行了回顾性分析。７例进行肾修补术,９例进行全肾切除术,４例进行非手术治疗,２０例均全愈出院。结果：肾损伤分为三型：肾包膜下血肿型,肾挫伤型,混合型;肾挫伤分为轻度、重度、危重性三类。结论：ＣＴ对准确诊断肾损伤,评估损伤程度,有无合并多脏器损伤,对治疗方案的选择有重要意义。     

CT in the diagnosis of renal trauma

Computed tomography (CT) is frequently employed as the initial diagnostic study in patients with known or suspected renal trauma, especially in large trauma centers where multiple-system injuries are common. In our 3-year experience, which encompasses over 2,500 CT scans for abdominal trauma, the following traumatic renal lesions were identified: renal contusion, small and large subcapsular hematomas, laceration, complete laceration, ureteropelvic junction disruption, fractured kidney, shattered kidney with and without an intact renal capsule, renal vein injury, renal artery thrombosis, avulsion, and trauma to the abnormal kidney. The CT findings and clinical features and management of each lesion are reviewed.     

肠及肠系膜钝挫伤的CT诊断

目的 探讨肠及肠系膜钝挫伤的CT表现.方法 对37例拟诊肠及肠系膜损伤的住院患者行CT扫描,在CT扫描后12 h内手术,并经手术和(或)病理证实肠及肠系膜损伤的部位及程度.术前就与肠及肠系膜损伤相关的5种CT征象双盲软读片.分别计算其诊断的灵敏度,特异度及总正确率.阅片结论与手术病理对照,采用配对四格表,运用Fisher确切概率法χ2检验.结果 本组术前综合运用主要CT征象对肠及肠系膜损伤的正确诊断率达86.5%(32/37).肠及肠系膜损伤的CT表现为肠壁增厚、腹膜腔游离气体影、肠系膜脂肪条索影、肠系膜血肿及肠壁周围积液影,其灵敏度分别为50.0%、16.7%、79.3%、23.1%和75.0%;特异度分别为85.7%、100%、40%,100%和44.4%.CT对肠及肠系膜损伤诊断与病理诊断没有显著性差异(χ2=3.2,P=0.073 6).结论 根据CT征象可在术前对肠及肠系膜钝挫伤做出较为准确的诊断.     

CT diagnosis of renal artery injury caused by blunt abdominal trauma

Controversy exists about the sensitivity of CT in the diagnosis of occlusion of the renal artery or one of its branches after blunt abdominal trauma. We report 10 cases in which contrast-enhanced CT was used to diagnose correctly either main (seven cases) or segmental (three cases) posttraumatic renal artery occlusion. The abnormality was proved angiographically and/or surgically in all cases. CT showed the absence of a nephrogram in the devascularized portion of the kidney in all 10 cases. A pyelogram was not shown on CT in the seven patients in whom the main renal artery was occluded, but was present in the three patients who had segmental arterial lesions. Termination of enhancement within the affected artery (renal artery cutoff sign) was observed in one patient, and a thin, peripheral rim of cortical enhancement in an otherwise unenhanced renal segment (rim sign) was observed in three patients. Retroperitoneal hematoma with renal displacement was present in nine patients. Our experience suggests that the absence of a nephrogram on contrast-enhanced CT scans is a useful sign of main or segmental renal arterial occlusion in patients with blunt abdominal trauma.     

闭合性肾损伤的诊断与治疗(附116例报告)

回顾分析 116例闭合性肾损伤的诊治资料 ,其中保守治疗 84例 (72 .4 % ) ,手术治疗 32例 (2 7.6 % ) ;肾切除 13例 ,死亡 2例。作者认为早期诊断和准确地进行伤情评估 ,严格掌握手术治疗指征是提高闭合性肾损伤治疗效果的关键。     

CT增强延时扫描在肾损伤诊断中的价值

目的：探讨CT增强延时扫描对肾损伤诊断的临床价值。方法：对9例肾损伤病人行螺旋CT普通扫描、增强扫描和增强延时扫描。结果：CT普通扫描显示肾轮廓不规则5例，肾包膜下血肿3例，肾周积血2例。CT增强扫描和延时扫描不仅显示普通扫描所见，而且显示外伤性假性动脉瘤形成1例，肾收集系统损伤导致尿外瘘2例，肾皮质穿通伤伴局限性肾包膜下陈旧积血1例，肾皮质裂伤1例，肾积水破裂导致腹腔积液1例。结论：CT增强延时扫描在肾损伤，尤其是收集系统损伤的诊断中很有价值。     

CT diagnosis of closed loop obstruction

A case of closed loop obstruction presenting with unremarkable plain abdominal films and diagnosed by CT is reported. The presence of (a) fluid filled distended small bowel loops; (b) abrupt transition with collapsed distal intestinal loops; and (c) grossly distended fluid filled "U" shaped loop are diagnostic of this entity. Prompt CT recognition, before signs of intestinal gangrene develop, will lead to immediate surgical decompression and a significant decrease in the morbidity and mortality of this potential abdominal catastrophe.     

肾损伤的CT诊断及临床治疗相关性研究

目的：研究复合性肾损伤的CT表现，探讨其对临床治疗的指导意义，方法：对58例肾损伤的CT资料及临床处理进行回顾性分析。结果：58例肾损伤中有肾挫伤10例，单纯肾包膜下血肿13例，肾挫裂伤14例，肾撕裂伤15例，肾粉碎伤2例，肾蒂伤4例，发现伤前肾脏疾病6例，肾外合并伤有肝脾破裂，肺挫伤，血气胸，多个部位骨折等，手术切除患肾5例，17例行肾动脉栓塞治疗。结论：CT对肾损伤的诊断迅速有效，对于损伤的分类，有无严重合并伤，是否需手术治疗及临床疗效的观察具有重要意义。     

CT diagnosis of abdominal trauma

Computed tomography (CT) findings from 95 patients with blunt abdominal trauma were evaluated. Among them, there was no false negative case. It can thus be said that if CT is negative the patient can be treated conservatively. The efficacy of CT in diagnosing injuries of various organs was also evaluated.