多层螺旋CT扫描对胸部损伤的诊断价值

目的探讨多层螺旋CT胸部损伤的CT表现及诊断价值。方法回顾性分析82例胸部外伤患者CT表现,并与X线平片比较。结果胸壁损伤60例,胸膜和/或肺实质损伤74例,纵隔、横膈伤9例,合并胸外脏器损伤17例。34例肺挫伤中,5例2 h内CT检查表现为单个或多发浅淡斑点状阴影,24 h后复查病灶呈大片不均匀致密影,而伤后2 h内X线胸片肺部未见明显异常。10例单根肋骨骨折中,X线诊断7例,10 mm层厚CT像上显示6例,薄层(3.75 mm层厚)CT像上骨折全部显示。结论多层螺旋CT对早期肺挫伤敏感,薄层重建图像能发现X线不易显示的骨折,是胸部损伤快速、准确的诊断方法。

EVALUATION OF MULTISLICE SPIRAL CT IMAGING FOR DIAGNOSIS OF THORACIC INJURY

Objective To discuss the appearance and clinical value of multislice spiral CT(MSCT) in thoracic injury.Methods The analysis of CT appearance of 82 cases with thoracic injury was performed retrospectively.And we compared it with X-ray films.Results With MSCT,injury of thoracotomy was diagnosed in 60 cases,pleura and/or lung parenchyma injury in 74 cases,mediastinum and disphragmatic muscle injury in 9 cases,ex-thoracic organ injury in 17 cases.CT imagings showed one or more pieces of light opacities 2 hours after injury in 34 cases of pulmonary contusion.And it showed large opacities with uneven high density after 24 hours.But it was normal in X-ray films 2 hours after injury.Of 10 cases of single rib fracture,7 were diagnosed by X-ray films,and 6 cases by CT imagings of 10 mm slice thick.But all of them were found by CT imagings of 3.75 mm slice thick.Conclusion MSCT is sensitive in the diagnosis of pulmonary contusion in the early period.And some fractures can be shown with thin reconstructed images which can not be detected in X-ray film.MSCT is a rapid and accurate method in diagnosing the thoracic injury.