肝脾外伤破裂的CT分析(附39例报告)

目的：为进一步提高肝脏及脾脏外伤性破裂的CT诊断水平。方法：39例经CT扫描诊断的肝脾外伤破裂病例，将CT所见与手术、临床结果对照分析。结果：肝脾外伤的CT改变主要分两种，肝脾撕裂伤表现为肝脾实质片状高密度灶7例，带状低密度影4例，片状不规则低密度区18例，其内可见多发斑点状高密度影11例；肝脾包膜下血肿表现为肝脾缘等或低密度新月形灶15例，部分新鲜血肿可为高密度灶。结论：肝脾外伤性破裂有诊断价值的CT征象主要有：①肝脾脏内不规则形高、低密度出血灶；②肝包膜下新月形低密度血肿；③腹农会内积血征。

Analysis of Liver and Spleen Traumatic Rupture with CT in 39 Cases

Purpose　To improve the diagnostic level of liver and spleen traumatic rupture in CT. Methods　39 cases of liver and spleen traumatic rupture diagnosed with CT images,analyzed comparing with CT findings,surgical outcome and clinical representation. Rusults　There are two categories of CT findings in cases of liver and spleen traumatic rupture. Liver and spleen traumatic avulsion: 7cases represented high density patches in liver and spleen parenchyma; 4cases represented low density zonary focus;18 cases represented irregular low density patches. 11 cases represented multi-spots of high density in above mentioned focuses. Hematoma under envelop of liver and spleen: 15 cases represented same or low density lunular focuses lying the edge of liver and spleen, some fresh hematoma represented high density. Conclusion　For diagnosing the liver and spleen traumatic rupture, following CT findings are valuable: ①Irregular high and low density bleeding focuses in liver and spleen; ②Lunular low density hematoma under envelop of liver; ③ Celiac hematocele symptom.