脾损伤的临床与CT分析和诊断注意点

目的:探讨钝性脾损伤的CT征象和诊断注意点。方法:回顾性分析85例钝性脾损伤病例和同期8例假阳性病例的临床与CT资料,并与手术对照。结果:85例中完全性脾破裂76例,单纯中心性破裂5例。单纯包膜下脾破裂4例。CT表现为腹腔积血(含脾周血肿),脾实质密度不均匀,轮廓模糊不规则,脾肿大或缩小,以及包膜下血肿。同时发现肝、肾、小肠、腰椎、肋骨等合并损伤。78例手术,7例保守治疗。结论:脾损伤病例CT检查具有重要作用,但仍有一定假阴性和假阳性,诊断时应注意多方面影响因素。

Analysis of Clinical and CT Manifestations in Splenic Trauma and the Point to Notice in Diagnosis

Objective To explore CT features of blunt splenic injury and some influential factors in diagnosis.Methods The clinical datum and CT manifestations of 85 cases with blunt splenic trauma and 8 cases be false positive diagnosied at the same time were retrospectively analyzed,and compared with the surgical results.Results Of 85 cases,there were 76 cases of ture splenic rupture,5 cases of pure central splenic rupture,4 cases of pure subcapscular rupture.CT manifestations were:hemoperitoneum(included perisplenic hematoma),the splenic essences were inhomogeneous density,its contours were irregular,an enlarged or lessened spleen,and subcapsular hematoma.CT also revealed other injuris including those of liver,kidney,lung,small intestines,lumbar spine and ribs.78 patients were underwent an operation for the splenic injury,7 cases were treated conservatively.Conclusion CT scans were important in diagnosis of blunt splenic trauma,but there were false negative and false positive examples.There were also some influential factors in diagnosis.