32例肾上腺外伤性钝性挫伤的CT征象分析

Analysis on CT Sign of 32 Cases of Adrenal Traumatic Blunt Trauma

目的分析探讨肾上腺外伤性钝性挫伤的CT征象及其诊断价值。方法回顾性分析32例肾上腺外伤性钝性挫伤患者的临床资料及CT检查结果。结果 32例患者中,男性24例,女性8例。其中,行CT平扫以及增强检查14例,行CT平扫18例,随访24例。所有患者均为单侧性损伤,26例位于右侧,6例位于左侧。25例CT表现为肾上腺区血肿,形状呈类圆形或卵圆形,其中7例CT表现为损伤侧肾上腺增粗,4例表现为肾上腺区弥漫性出血,另外4例存在原有的肾上腺肿瘤症状。邻近肾上腺的脂肪内出血呈现束状或局限性密度增高的21例,占总人数的64.00%,后肾周间隙出血10例,占31.25%,表现为类似膈脚增厚的改变。所有患者均伴有不同程度的胸腹腔或腹膜后脏器损伤。结论肾上腺损伤的直接CT征象为出血与血肿,右侧损伤的概率明显高于左侧,且损伤的同时通常有伴随性损伤。通过CT征象对肾上腺外伤性钝性挫伤能够做出明确的诊断。

Objective To analyze CT sign of adrenal traumatic blunt contusion and explore its value for diagnostic. Methods A retrospective analysis was done in 32 cases of adrenal traumatic blunt contusion patients with their clinical data and CT signs. Re- suits 32 cases of patients, male 24 cases, and female 8 cases. Among them, 14 cases underwent the examination of plain CT scan and enhanced CT scan, 18 cases only underwent the examination of plain CT scan, and 24 cases underwent the CT follow-up. All of the patients were unilaterally injured, 26 cases were located in the right side and 6 cases were in the left side. 25 patients showed the CT signs of adrenal haematoma, round or ovoid. 7 patients with CT signs of the adrenal gland of the damage side was thickening, and 4 cases showed the diffuse hemorrhage of the adrenal gland among them. In addition, there are 4 cases had the original adrenal tumors. Hemorrhage in the adjacent fat of adrenal which presented fasciculate or local high density were 21 cases, accounting for 64.00% of the total, 10 cases had the hemorrhage after the perirenal space showed the similar change of the diaphragmatic foot thickening, ac- counting for 31.25%. All patients were associated with different levels of injuries in pleural and peritoneal or retroperitoneal. Conclu- sions The direct CT sign of adrenal injuries were hemorrhage and hematoma. The probability of injury in the right side is significantly higher than the left side, and the injury is often associated with concomitant injuries. The adrenal traumatic blunt contusion can be made definite diagnosis by the observation of CT signs.