螺旋CT在肾上腺钝性损伤中的诊断价值.docVIP

fhd1975@163.com 螺旋CT在肾上腺钝性损伤中的诊断价值 范合灯 （邛崃市医疗中心医院放射科 611530） 【摘要】目的 讨论螺旋CT在肾上腺钝性损伤中的诊断价值。方法 回顾性分析我院收治随访明确诊断11例肾上腺钝性损伤的CT表现。结果 本组患者右侧肾上腺损伤9例(81.82%)，左侧2例（18.18%）。形成血肿7例(63.63%)，表现为圆形或卵圆形肿块影，其中迟发性血肿两例；肾上腺挫伤4例(36.37%)，表现为肾上腺局限性或弥漫性增粗，肿胀。CT复查表现为肾上腺血肿体积缩小，密度从边缘开始逐渐降低，肾上腺形态缓慢恢复；其中5例完全吸收，1例形成机化结节，1例形成假性囊肿。4例肾上腺挫伤随访复查其形态逐步恢复。结论 肾上腺钝性损伤具有特征性CT表现，螺旋CT对肾上腺钝性损伤具有重要诊断价值，可作为首选方法。 【关键词】肾上腺；钝性损伤；体层摄影术；X线计箅机 Spiral CT diagnostic value of adrenal gland blunt injury Fan he-deng Department of radiology,QiongLai city hospital medical center ，QiongLai，ichuan Province 611530,P.R.China [Abstract] Objective To discuss the spiral CT diagnostic value of adrenal gland blunt injury.Methods The CT imaging features of 9 cases adrenal injury verified by following up were analyzed retrospectively. Results 9 cases (81.82%)were on the right side ,2 cases （18.18%）were on left side, 7 (63.63%) of them formed hematomas, which exhibited round or roundish shadow .2 of them was delayed hematoma; 4 cases(36.37%) in this group were adrenal bruise. Adrenal bruise exhibited Adrenal glands diffuse thickening and swelling.Following up the adrenal hematomas after injury and they were found that the density of shadow reduced from margin of hematomas and that the shapes of adrenal gland recovered gradually.5 of them were complete disappearance,1 of them was formed organized nodule,1 of them revealed cystic change. Following up the adrenal bruise (4 cases) and found that Their shapes of adrenal gland recovered gradually.Conclusion adrenal gland blunt injury has the characteristic CT appearance, CT examination is of significant value in diagnosis of adrenal blunt injury.and spiral CT is the first method for diagnosis of adrenal injury. [Key words] Adrenal glands; blunt injury; Tomography ；X-ray computer 肾上腺体积较小，为腹膜后位器官,位于腹膜后深处，且周围有其它脏器保护，还有以前受检查设备限制，因此，肾上腺损伤在腹部钝伤中报道较为少见，国外以往报道肾上腺损伤占腹部钝伤CT检查病人的2%[1]。随着医学检查设备更新，螺旋CT在临床诊断中的广泛应用,发现肾上腺损伤病例增多趋势。笔者通过对2009~2012年共收集的11例随访确诊为外伤致肾上腺损伤的患者CT扫描资料进行分析，目的在于提