超声造影及增强CT诊断肾脏外伤的对比研究

A comparative study of kidney trauma diagnosed by contrast-enhanced ultrasonography and contrast-enhanced CT

目的评价超声造影(contrast-enhanced ultrasonography,CEUS)与增强CT在肾脏外伤诊断中的应用价值。方法 57例肾脏外伤患者分别进行超声造影与增强CT检查,根据美国创伤外科协会(AAST)肾外伤分级标准及肾外伤CT分级判断外伤程度,并对结果进行对照研究。结果超声造影发现1例I级肾外伤,而增强CT未发现;CEUS漏诊2例I级肾外伤;1例CEUS将Ⅲ级高估为Ⅳ级;2例将Ⅳ级低估为Ⅲ级。增强CT与CEUS各自的诊断符合率分别为98.2%、91.2%,两者诊断结果具有较好的一致性(P=0.000)。结论 :CEUS在评价实质器官外伤上具有优势,而增强CT在判断腹部合并伤方面更具优势,两种检查技术的有机组合必将大大提高诊断准确率。

Objective To evaluate the application value of contrast-enhanced ultrasonography （CEUS） and Contrast-enhanced CT in diagnoses of kidney trauma. Methods CEUS and Contrast enhanced CT were performed on 57 patients with kidney trauma. According to the classification of kidney trauma by AAST as well as the CT grading of kidney trauma, the trauma degree was judged, and a comparative study of the results was performed. Results One case of grade I kidney trauma was found using CEUS, yet Contrast-enhanced CT failed to find sucha case. Two cases of Grade I kidney trauma were missed using CEUS. Besides, CEUS wrongly diagnosed one case of Grade III kidney trauma as Grade IV, and under- estimated two cases of Grade IV as Grade III. The diagnostic coincidence rates of Contrast-enhanced CT and CEUS were 98.2% and 91. 2% respectively. Their diagnosis results were of good consistency （ P = 0. 000）. Conclusion CEUS shows significant advantages in evaluation of substantial organ trauma, while Contrast-enhanced CT performs better in judgment of associated abdominal injuries. Organic combination of these two technologies will definitely increase the accuracy rate of diagnosis.