肾创伤的CT诊断

目的 探讨ＣＴ对确定肾损伤范围和提供手术指征方面的价值。 方法 回顾分析了３２例肾创伤病人的ＣＴ表现。 结果 ＣＴ清楚地显示了肾创伤的三种基本类型：挫伤、裂伤、梗塞；将裂伤分为：小的表浅裂伤、大的深部裂伤有／无尿外渗、断裂伤、粉碎伤；通过增强后无血供的肾断片或梗塞灶无增强，ＣＴ可以间接诊断血管撕裂或动脉闭塞；ＣＴ能确定血肿和尿外渗的范围；检出了腹腔和腹膜后损伤及肾的原有异常。 结论 ＣＴ为所有肾损

RENAL TRAUMA DIAGNOSED BY COMPUTERIZED TOMOGRAPHY

Objective To assess the value of computerized tomography (CT) for staging renal injuries and indicating surgical intervention.Methods The CT finding of 32 patients with renal trauma were reviewed and analysed.Results CT could clearly define the 3 basic types of renal injury, contusion, laceration and infarction. The laceration could further be classified into minor or superficial laceration, major or deep medullary laceration with/without extravasation, fractured kidney and fragmented kidney.Renal vascular avulsion and arterial occlusion could be demonstrated in CT after contrast enhancement. CT could define the extents of hematoma and urine extravasation,and could also reveal various injuries in other viscera as well as originally existing abnormalities, such as polycystic kidney and urinary stone.Conclusion CT can provide sufficient information for proper management of paients with renal trauma, and the CT findings are dependable and confirmable on operating table. Surgical indications suggested by CT include major laceration with extracapsular extravasation, big devascularized kidney segment, fragmented kidney, severe renal vascular injuries and other major surgical complications.