多层螺旋CT增强扫描对钝性肾损伤的诊断价值及临床意义

Diagnostic value and clinical significance of multi-slice spiral CT enhanced scanning in blunt renal trauma

目的探讨多层螺旋CT（MSCT）增强扫描对钝性肾损伤的诊断价值和临床意义。方法笔者回顾性分析2010年2月-2014年12月收治的122例钝性肾损伤患者的临床资料,其中男性94例,女性28例;年龄9-71岁,平均41岁。道路交通伤34例,高处坠落伤54例,其他34例。所有患者均接受MSCT扫描,96例患者进行增强扫描,患者取仰卧位,扫描范围为膈顶至耻骨联合,增强扫描包括皮质期、髓质期,47例还进行了排泄期扫描。结果根据美国创伤外科协会肾损伤分级标准将122个病例分为Ⅰ-Ⅴ级,本组患者中Ⅰ级26例,Ⅱ级26例,Ⅲ级44例,Ⅳ级14例,Ⅴ级12例。结论 MSCT增强扫描对钝性肾损伤患者的诊断和分级有重大的价值,为临床治疗方案的选择有着重要的意义。

Objective To evaluate the diagnostic value and clinical significance of multi-slice spiral CT（ MSCT） enhanced scanning in blunt renal trauma. Methods The clinical data of 122 patients with blunt renal trauma treated in our hospital from Feb. 2010 to Dec. 2014,including 94 males and 28 females with an average age of 41（ 9-71） years,were retrospectively analyzed. There were 34 cases injured by traffic accident,54 cases by high falling and 34 cases by other causes. All of these cases underwent abdomen MSCT scans and 96 cases underwent enhanced scans. All of these patients were scanned in the supine position and the scan range was from the diaphragm to symphysis pubis. We used MSCT for the corticomedullary phase and the nephrographic phase enhanced scanning. Totally 47 patients performed excretory phase scan. Results The 122 cases were divided into Ⅰ-Ⅴgrades according to American Association for the Surgery of Trauma Organ Injury Severity Scale for the Kidney. Among them 26 were grade Ⅰ,26 were grade Ⅱ,44 were grade Ⅲ,14 were grade Ⅳ and 12 were grade Ⅴ. Conclusion The MSCT enhanced scanning has great value on diagnosis and classification of patients with blunt renal trauma. It also plays an important role in the choice of the treatment.