CT增强扫描在肝脏创伤中诊断价值分析.docVIP

CT增强扫描在肝脏创伤中诊断价值分析 　　【摘要】目的 探讨分析CT增强扫描在诊断肝脏创伤中的作用与价值。方法 选取我院自2009年10月至2010年8月收治的38例肝脏创伤患者，所有患者均与伤后行CT检测，其中18例行CT增强扫描。将患者肝脏创伤扫描影像与其手术结果进行比较分析。结果 38例经过CT检查后肝实质内有不规则的低密度影，肝脏周围和脾周围等部位的液性低密度影是腹腔内积血的重要CT征象，有5例患者漏诊，漏诊率为13.16%，有3例经强化确诊，2例经过手术确诊；18例经过强化扫描后，损伤部位和程度均清晰显示，无漏诊。结论 肝脏平扫加增强扫描能清晰显示肝脏损伤的部位和程度，诊断正确率高，值得在临床推广。 　　【关键词】CT增强扫描 肝脏创伤 诊断 　　中图分类号：R814.42 文献标识码：A 文章编号：1005-0515（2011）6-007-02 　　CT scan in the diagnosis of liver trauma of 　　ZHANG ShaoJin TANG Cheng XU Qixian 　　(Pi County of Sichuan Province Peoples Hospital, Department of Radiology, Chengdu 611730) 　　【Abstract】Objective To explore CT scan in diagnosis of liver trauma in the role and value. Methods in our hospital from October 2009 to August 2010 were treated 38 cases of liver trauma patients, all patients underwent CT detected with injuries, 18 of which enhanced routine CT scan. Hepatic trauma in the patient scan images were compared with surgical results. Results 38 patients after a CT examination of liver parenchyma with irregular low density, surrounding the liver and spleen and other parts of the surrounding low density liquid is important hemoperitoneum CT signs, 5 patients with missed diagnosis, missed diagnosis 13.16%, with 3 cases diagnosed by enhanced, and 2 cases confirmed by surgery; 18 patients with an enhanced scan, the location and extent of damage are clearly displayed and no misdiagnosis. Conclusion The plain and enhanced liver scan can clearly show the location and extent of liver injury, the diagnostic accuracy rate, it is in the clinic. 　　【Key words】 CT enhanced scan diagnosis of liver trauma 　　 　　近年来随着交通事故的不断增加，腹部损伤发生率也逐年升高，肝脏损伤在腹部损伤中比较常见，仅次于脾损伤，随着CT的广泛应用[1]，肝脏损伤诊断正确率也逐渐升高，CT增强扫描可以更清晰的显示肝脏损伤的部位和损伤程度，效果满意，先将诊断报告总结如下： 　　1 资料和方法 　　1.1 一般资料 选取我院自2009年10月至2010年8月收治的38例肝脏创伤患者，男性27例，女性11例，年龄在13~71岁之间，平均36.4±4.8岁，损伤时间在30min~10d之间。 　　1.2 方法 所有患者均采用西门子公司SOMATOM Spirit螺旋CT机作横断面扫描，层厚、间距5~10mm，窗宽250~400HU，窗位25~40HU，在扫描之前4h口服1%泛影葡胺500ml，2h后再服用500ml[2]，18例患者做了增强扫描，对于不能控制活动的患者，给予适量镇静剂，避免运动伪影。