超声造影在肝脾外伤中的应用

Application of contrast-enhanced ultrasonography in liver and spleen trauma

目的探讨超声造影在肝脾外伤中的应用。方法 60例肝脾外伤患者,先行常规超声检查,再行超声造影检查,据肝脾损伤程度分级而分别处理。结果 6例常规超声显示肝或脾可疑病灶及腹盆腔积液,超声造影提示肝或脾内未见明确病灶。9例常规超声未显示可疑病灶,仅显示腹盆腔积液,超声造影提示肝或脾内明确病灶;45例常规超声与超声造影均提示肝或脾血肿病灶。与常规超声比较,超声造影检查病灶范围较大,病灶数量较多,差异有统计学意义(P<0.05)。54例肝脾损伤患者,保守治疗23例,ICU监护+保守治疗6例,手术治疗25例。结论超声造影在肝脾外伤的鉴别诊断和治疗中起重要作用。

Objective To investigate the application of contrast-enhanced ultrasonography （CEUS） in liver and spleen trauma. Methods Sixty trauma patients including liver or spleen trauma were examined using both conventional ultrasonography （US） and CEUS. According to the level of liver and spleen injury, patients were treated respectively. Results In 6 cases, doubtful lesions and ascites were found by US, but no specific lesions in the liver or spleen were found by CEUS; In 9 cases, doubtful lesions were not found and ascites were found by US, specific lesions were found in the liver or spleen by CEUS. Hematoma lesions were found in 45 cases by two methods. Compared with US, lesion ranges and numbers examined by CEUS were larger （P〈0.05）. In 54 patients with liver and spleen trauma, 23 cases were expectant treatment, 6 cases were expectant treatment and cared in ICU and 25 cases required surgery. Conclusion CEUS plays an important role in the differential diagnosis and treatment of liver and spleen trauma.