外伤性脾破裂的CT诊断(附38例分析)

Computed Tomography Diagnosis of Traumatic Rupture in Spleen:Analysis of 38 Cases

目的：评价ＣＴ在外伤性脾破裂诊断中的价值。材料与方法：本文报告３８例外伤性脾破裂，其中２２例经手术证实。３８例均作ＣＴ平扫，其中３例平扫２次，加作增强２例。男３１例，女７例。以３０～４９岁最多见。结果：ＣＴ表现以脾实质内不规则不均质低密度影最多见。运用窄窗及图像放大技术能使损伤更清楚。肝周新月形低密度影是脾破裂腹腔内积血的常见ＣＴ征象。也可同时发现肝、肾、肋骨、脊椎、横膈等多发性损伤。但对肠系膜后腹膜破裂、胰尾血肿、小肠浆膜撕裂各１例ＣＴ未能发现。结论：本组ＣＴ诊断脾破裂无１例假阳性。

Objective: To evaluate the clinical application value of CT in diagnosis of traumatic rupture in spleen.Materials and Methods:This article reported 38 patients with traumatic rupture of spleen. 31 were male, 7 were female.Results:Irregular and heterogeneous lowdensity shadow is a very important and more common sign in rupture of spleen on CT image, and the lowdensity shadow around the liver is an important and more common sign in hematocelia with rupture of spleen on CT image. It is pointed that to make use of narrow window width, magnification for image and enhancement CT are helpful in showing lesion.Conclusion: The is no falsepositive case in rupture of spleen in our study, at the same time multiple trauma can be found by CT.