一站式MSCT检查及图像后处理技术在急性胸腹部复合伤中的应用价值

目的评价一站式MSCT检查及图像后处理技术在急性胸腹部复合伤(ATACI)中的应用价值。方法对300例ATACI患者行一站式MSCT检查的影像资料进行分析,并与149例胸部CR、94例腹部US的相关影像学资料进行对比分析;对300例ATACI患者行16层螺旋CT薄层容积扫描的数据进行图像后处理,包括MPR、CPR、MIP、MinP以及VR等,并与轴位图像进行对照分析。结果 MSCT对胸壁外伤、胸膜外伤、肺损伤、纵隔损伤、膈肌损伤以及骨与关节损伤的检出与CR比较差异均有统计学意义(P0.05);对腹腔少量积血、气腹、膈肌以及骨损伤与US比较差异均有统计学意义(P0.05)。单纯CT轴位图像与轴位图像联合后处理图像对胸壁损伤、胸膜损伤、纵隔损伤、膈肌损伤以及骨与关节损伤的检出比较差异均无统计学意义(P0.05);对肺损伤、腹部损伤的检出比较差异均有统计学意义(P0.05);对胸壁损伤、胸膜损伤、纵隔损伤的定位诊断比较差异无统计学意义(P0.05);对肺损伤、腹部损伤、膈肌损伤以及骨与关节损伤的定位诊断比较差异均有统计学意义(P0.05)。结论一站式MSCT检查能在最短的时间内得到大量的诊断信息,为临床及时、准确救治提供了重要的依据,应列为ATACI首选检查手段;轴位图像联合后处理图像对ATACI作出准确和"立体"判断具有重要意义,应常规使用。

Value of One-stop MSCT Scan and Image Post-processing Technique in the Diagnosis of Acute Thoracic-abdominal Compound Injury

Objective TO evaluate the value of one-stop MSCT scan and image post-processing technique in the diagnosis of acute thoracic-abdominal compound injury（ATACI）. Methods The images of 300 ATACI patients accepted one-stop MSCT scan were compared with chest CR of 149 patients and abdomen US of 94 patients. The images of 300 ATACI patients underwent 16-slice spiral CT scanning were post-processed, including MPR, CPR, MIP, MinP and VR, and comparing with the axial images. Results There were significant differences in the detection of MSCT on thoracic wall injury, pleural injury, lung injury, mediastinal injury, diaphragmatic injury, bone and joint damage comparing with the CR（P〈0.05）; There were significant differences in the detection of MSCT on a small amount of intraperitoneal hemorrhage, pneumoperitoneum, diaphragm and bone damage comparing with US（P〈0.05）. Between CT axial images and axial image combined with post-processing image, there was no significant difference in the detection of thoracic wall injury, pleural injury, mediasfinal injury, diaphragmatic injury, bone and joint damage（P〉0.05）, significant differences in lung injury, abdominal injury（P〈0.05）, no significant difference in the localization diagnosis of thoracic wall injury, pleural injury, mediastinal injury（P〉0.05）, significant differences in the localization diagnosis of lung injury, abdominal injury, diaphragmatic injury, bone and joint damage（P〈0.05）. Conclusion One-stop MSCT examination should get a lot of diagnostic information in the shortest time and provide an important evidence for clinical treatment, so it should be first choice of ATACI; There were important significance in accurate and stereo estimation on ATACI by Axial image combined with post-processing images.