灰阶超声造影与CT在脾脏外伤诊断中的比较

目的评价灰阶超声造影与CT在脾脏外伤诊断中的价值。方法在全麻开腹状态下建立脾脏钝性伤和锐性伤动物模型，6只小型猪共建立脾脏外伤模型13处，其中锐性伤5处，钝性伤8处。脾脏创伤后即刻，首先应用常规超声观察脾实质损伤的部位、范围及内部回声，然后在灰阶超声造影条件下静脉团注自制造影剂1．8ml，观察脾实质损伤的部位、范围、损伤程度及造影增强特征，并与增强CT、病理学检查进行对照分析。结果灰阶超声造影可清晰显示脾内损伤病灶的部位、形态、范围，其显示脾内损伤区的敏感性为100％（13／13）。增强CT可清晰显示脾内的9个损伤灶，另4个脾内损伤灶未显示，敏感性为69％（9／13），超声造影显示此4个损伤灶损伤程度为Ⅰ级，敏感性高于CT（P＜0．01）。在判断脾损伤的严重程度上，超声造影分级与病理学检查具有较好的一致性。结论超声造影剂结合灰阶超声造影技术可显著提高常规超声对脾脏外伤的诊断水平，和CT比较具有一定的优势。

Gray Scale Contrast-enhanced Ultrasonography and CT Scan in Diagnosis of Splenic Trauma

Objective To compare the diagnostic value of gray scale contrast-enhanced ultrasonography(CEUS) in the diagnosis of splenic trauma with CT.Methods Thirteen splenic trauma lesions including 5 piercing and 8 blunt lesions were in 6 pigs after the animals were anesthetized.Conventional ultrasonography and gray scale CEUS were performed to detect the positions and dimensions of the traumatic lesions.The results of CEUS were compared with enhanced-CT and pathologic findings.Results The position,morphology and range of the traumatic lesions were displayed clearly on the enhanced images.The sensitivity of gray scale CEUS detecting the traumatic lesions was significantly higher than that of CT scan(100% vs 69%),(P=0.000).Enhanced CT only displayed 9 lesions.Two of the another 4 misdiagnosed lesions on CT were clearly displayed as grade I on gray scale CEUS.The grades of splenic trauma evaluated by CEUS were consistent with pathology to judge the severity.Conclusions Gray scale CEUS may improve the diagnostic accuracy of ultrasound and is superior to CT in the diagnosis of the disease.