钝性肾外伤的多层螺旋CT诊断

目的探讨钝性肾外伤的多层CT检查方法和影像诊断。方法对病例资料完整的28例钝性肾外伤的肾脏,多层CT双肾平扫及增强后28 s、60 s、3~5 min三期(皮质期、实质期和肾盂期)扫描后详细观察分析。结果28例患肾中肾实质挫伤水肿8例,肾实质挫伤并肾实质内出血6例,肾实质撕裂11例,合并肾周尿液外漏5例;肾实质碎裂伴肾盂肾盏撕裂伤致肾盂肾盏积血2例,肾蒂血管撕裂伤1例。增强CT可直接显示肾实质裂口,并明确和鉴别包膜内、外肾周出血。增强CT肾脏分泌期观察到对比剂漏出是诊断尿漏的直接征象,且CTU可显示整个漏出路径;通过CTA技术非常直观地再现肾脏供血动脉及肾静脉形态、走形及裂口,对肾蒂撕裂的诊断有独特价值。结论多层螺旋CT具有快速扫描和优良图像分辨率,辅之以多种图像后处理技术,对钝性肾脏外伤的诊断有着重要的优势。

Multi-Slice CT Diagnosis of Blunt Renal Injuries

Objective To discuss MSCT(multi-slice computerized tomography) technique and manifestation of blunt renal injury.Methods A total of 28 bluntly wounded kidneys with intact clinical data were studied.Their plain scan and enhanced CT investigation at three phases were analyzed carefully.Results In all the 28 wounded kidneys,there were eight cases of renal edema and contusion,six cases with renal parenchyma hemorrhage,11cases of renal laceration,five cases with ureteral fistula,two cases of parenchyma broken with ureter hemorrhage,and one case of renal vessel laceration.CT urography could display the leaking path which was the reliable sign of ureteral fistula in enhanced CT.CT angiography could render renal artery and vein vividly which was very useful in renal vessel laceration diagnosis.Conclusion MSCT get advantage such as high speed scan,excellent discrimination,and aplenty post-process technique so as to be of great value to renal injury diagnosis.