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。

A discussion for classification of blunt renal trauma with multislice spiral CT

Objective To evaluate the value of CT and MRI in the diagnosis of spinal metastases.Methods CT and MRI data of 55 patients with clinically and pathologically proved spinal metastases were analyzed retrospectively.Results CT and MRI demonstrated 123 involved vertebral bodies,89 involved appendages,53 involved vertebral canals,65 paravertebral soft tissue masses,and 12 pathological fractures in 55 patients.CT showed three-patterns of bony changes which comprised osteolytic,osteogenic and mixed bony destructio...