腹部闭合性内脏损伤的超声及CT诊断价值分析

Analysis of the Diagnostic Value of Ultrasonography and CT in Abdominal Closed Visceral Injury

目的探讨腹部闭合性内脏损伤的超声及CT诊断价值。方法选取医院收治的86例腹部闭合性损伤(BAT)患者作为研究对象,入院后均行B超、CT诊断,并与临床手术结果对照,分析两种影像学的诊断符合率及影像学表现。结果以手术结果为金标准,70例(89处伤)BAT合并脏器受损,CT诊断符合率为91.01%较超声76.40%高,差异显著(P<0.05);CT诊断BAT合并空腔脏器的符合率为92.86%较超声60.71%高,差异显著(P<0.05)。实质性脏器损伤超声表现为受损脏器体积增大,有不均匀回声;包膜下出血为脏器局部隆起,出现低回声区或无回声区;完全破裂表现为脏器原有形态改变,回声不均匀,周围有无回声区;CT影像学表现为受损脏器体积增大,可见不均匀密度影,增强扫描更为清晰;包膜下出血出脏器隆起,呈新月状,血肿部位不强化;完全破裂可见脏器形态改变,有稍低密度影。结论超声和CT诊断BAT合并实质性脏器的一致性较高,但CT诊断BAT合并空腔脏器受损的准确率高于超声。

Objective To investigate the diagnostic value of ultrasonography and CT in abdominal closed visceral injury.Methods 86 cases of patients who had abdominal closed injury（BAT）were selected as the research objects.After admission,all the patients were diagnosed by ultrasonography and CT,and the results were compared with the clinical surgical results.The coincidence rates and imaging findings of the two kinds of imaging diagnotic methods were analyzed.Results The surgical findings were treated as the gold standard.There were 70 cases （89injuries） of BAT with visceral injury.The diagnostic coincidence rate of CT was 91.01% which was higher than 76.40% of ultrasonography and the difference was significant （P〈0.05）.The coincidence rate of CT in the diagnosis of BAT with hollow organ was 92.86% which was higher than 60.71% of ultrasonography and the difference was significant （P〈0.05）.The ultrasound findings of parenchyma organ injury showed increasing volume of damaged organ,with uneven echo;Subcapsular hemorrhage manifeasted as organ local eminence,with hypoechoic or anechoic area;Complete rupture manifested as the change of the original morphology of organ,uneven echo and anechoic area around;CT imaging showed enlargement of the damaged organ volume and visible uneven density shadow.After enhancement scan,they were clearer.Subcapsular hemorrhage with organ eminence was crescent shaped and the hematoma part was not enhanced; Organ morphological changes were visible in complete rupture with relatively low density shadow.Conclusion The consistency of ultrasonography and CT in diagnosis of BAT with parenchyma organ is high, but the accuracy of CT in diagnosis of BAT with parenchyma organ is higher than that of ultrasonography.