肾损伤的CT诊断及其临床价值

Clinical Value of CT Diagnosis of Renal Trauma

目的 评价肾损伤的检查方法 ,探讨CT诊断和分类的临床价值。材料与方法 对 70例肾损伤CT表现作回顾性分析。结果 70例中左肾损伤 3 9例 ,右肾 3 0例 ,双肾 1例。CT表现为肾影增大 3 0例 ( 4 2 .9% ) ,肾轮廓不规则 15例 ( 2 1.4% ) ,肾包膜下血肿 43例 ( 61.4% ) ,肾内血肿 3 5例 ( 5 0 .0 % ) ,肾周积血 2 9例 ( 4 1.4% ) ,肾节段性梗塞 8例 ( 11.4% ) ,轻度肾实质挫伤 4例 ( 5 .7% ) ,肾撕裂或断裂 41例 ( 5 8.6% ) ,肾粉碎 5例 ( 7.1% ) ,肾动脉主干断裂或闭塞 2例 ( 2 .9% )。另外尚有肝、脾破裂等合并伤表现。结论 CT平扫加增强检查对肾损伤定性诊断准确率达 10 0 % ,分类诊断准确率达 92 .7% ,CT分类对临床选择治疗方案有重要指导价值。

Objective To evaluate the examination methods of renal trauma, and application of CT in diagnosis and classification of the disease.Materials and Methods Renal trauma on CT scans was retrospectively analyzed in 70 patients.Results Of the total 70 cases with renal trauma, 39 ones were involved in the left kidney, 30 ones in the right kidney and only one in both kidneys. CT showed kidney enlargement in 30 cases (42.9%), marginal irregularity in 15 (21.4%), subcapsular hematoma in 43 (61.4%), intra renal hematoma in 35 (50.0%), perinephric hemorrhage in 29 (41.4%), segmental infarction in 8 (11.4%), minor parenchymal contusion in 4 (5.7%), laceration or tear in 41 (58.6%), shattered kidney in 5 (7.1%), disruption or occlusion of the main renal artery in 2 (2.9%). In addition, combined liver or spleen injuries were discovered in several cases.Conclusion Plain and enhanced CT scans proved to be the best method of choice in assessing renal trauma, with an accuracy rate of diagnosis (100%) and classification (92.7%). Accurate CT classification of the disease may play an important role for clinical management strategy.