脾损伤的CT研究

CT of spleen injury

目的探讨脾损伤cT诊断分级的准确性，并分析脾损伤CT分级对临床治疗的价值。方法对照分析118例脾损伤CT分级与临床手术结果。结果CT结果示：包膜下血肿45例，实质内血肿73例，脾撕裂22例，脾周血肿18例，腹腔积血32例。CT诊断分级与临床手术分级对照：Ⅰ-Ⅳ级符合例数分别为16、27、19、13例，Ⅰ-Ⅳ级符合率分别为84．2％、84．4％、82．6％、92．8％；非手术治疗30例，其中CT诊断Ⅰ-Ⅳ级分别为21、7、2、0例，主要为Ⅰ和Ⅱ级。结论CT检查是诊断脾损伤的有效方法，且CT分级对临床治疗的选择有一定帮助。

Objective To explore the accuracy of CT grading in the diagnosis of spleen injury and analyze the clinical treatment value of the CT grading of spleen injury. Methods The CT grading and surgical outcomes in 118 cases with spleen injury were comparatively analyzed. Results The CT demonstrated that 45 got subcapsular hematoma, 73 parenchymal hematoma, 22 splenic laceration, 18 perisplenic clot, and 32 hemoperitoneum. Comparison between CT grades and clinical surgical grades： the identical cases in grade 1 to 4 were 16, 27, 19, and 13, respectively; the coincidences in grade 1 to 4 of CT grading with surgical results were 84.2%, 84.4%, 82.6 %, and 92.8%, respectively. 30 patients undertook conservative treatment, of which 21, 7, 2, and 0 cases were graded as CT grade 1 to 4, respectively, and most of which were included into grade 1 and 2. Conclusions CT is a highly reliable method for evaluating spleen injury and CT grading is helpful for selecting proper therapy.