家兔肺挫伤早期影像学的变化及其意义

Early radiological change and its significance on experimental pulmonary contusin in rabbits

目的 探讨单光子发射计算机断层显像(SPECT)、胸部CT以及X线平片对家兔肺挫伤的早期诊断价值。方法 建立兔单侧胸部撞击伤动物模型,采用SPECT、胸部CT以及X线平片对兔肺挫伤进行早期诊断,并与病理解剖结果进行对照观察。结果 在伤后1、6、24小时,X线诊断肺挫伤的敏感性分别为33.33％(3／9)、55.56％(5／9)、75.00％(6／8),有2只动物未检出肺挫伤病变。在伤后1小时,CT显示双肺均有挫伤100％(2／2),结合动物病理观察,CT与实际伤情非常吻合,而X线低估了肺挫伤的病变范围。结论胸部CT在诊断胸部创伤获得治疗相关信息方面明显优于X线平片。因此,对于严重胸部创伤以及多发伤,急诊检查应采用CT扫描,以尽快明确诊断。

Objective To explore the early diagnostic value of single photon emission computerized tomography (SPECT) ,thoracic computerized tomography(TCT) and chest X-ray(CXR) on experimental pulmonary contusion in rabbit. Methods The animal model of unilateral chest impact trauma was established, pulmonary contusion was diagnosed by SPECT,TCT>and CXR,and observed by postmortem examination. Results At 1,6, and 24 hours after trauma, the pulmonary contusion diagnostic sensibility of CXR were 33.33% (3/9) ,55.56% (5/9) ,and 75.00% (6/8) respectively. Contusions escaped detection in 2 rabbits(22.22% ,2/9)on conventional radiographs, whose contusions were visible by TCT at 1 hour after trauma, and the size of lesions found by CT were identical with practical pulmonary contusion volume observed in autopsy,but the size of lesions of pulmonary contusion were underestimated by chest X-ray. Conclusion To obtain the information of diagnosis and treatment on chest trauma,TCT is superior to conventional radiograph. For the severe chest trauma and multiple injuries,TCT examination should be adopted at first in order to diagnosis as clearly as possible.