腹部实质脏器闭合性外伤的超声及CT影像表现与诊断分析

An Imaging and Diagnostic Analysis of Ultrasound and CT in Abdominal Solid Organ Closed Trauma

目的比较分析腹部实质脏器闭合性外伤超声、CT影像表现及诊断价值。方法以我院2014年1月至2015年12月经手术病理证实的100例腹部实质脏器闭合性外伤患者为研究对象,所有患者入院时接受超声、CT检查,观察各自影像表现,并以手术病理结果为对照,比较超声、CT对腹部实质脏器闭合性外伤诊断符合率。结果手术病理证实腹部实质脏器闭合性外伤共118个,其中多脏器损伤28个。以手术病理结果为对照,CT诊断脾脏损伤符合率、多脏器损伤符合率、总符合率分别为89.28%、100.00%、90.68%,均显著高于超声的71.43%、85.71%、80.51%,差异有统计学意义(P<0.05)。超声诊断肝脏损伤、肾脏损伤符合率分别为85.36%、95.24%,较CT的90.24%、95.24%差异无统计学意义(P>0.05)。腹部实质脏器闭合性损伤超声特点为损伤脏器体积变大,不均匀回声;CT特点为损伤脏器体积变大,不均匀密度影,增强扫描更明显。结论超声与CT在腹部肝脏及肾脏损伤诊断准确率类似,但CT在多脏器损伤、脾脏损伤诊断上更有优势。

Objective To compare and analyze the imaging findings of ultrasound and CT and their value in the diagnosis of abdominal solid organ closed trauma. MethodsOne hundred cases of patients with abdominal solid organ closed trauma confirmed by operation and pathology in our hospital between January 2014 and December 2015 were selected as the study object. All patients underwent ultrasound and CT examination on admission. Their imaging findings were observed. The results of operation and pathology were taken as the contrast to compare the coincidence rates of ultrasound and CT in the diagnosis of abdominal solid organ closed trauma. Results Operation and pathology confirmed that there were 118 closed injuries of abdominal solid organs and 28 of them were multiple organ injuries. The operative and pathological results were taken as control. The coincidence rates of CT in diagnosis of splenic injury and multiple organ injury and the total coincidence rate（89.28%, 100.00%, 90.68%） were significantly higher than those of ultrasound（71.43%, 85.71%, 80.51%）（P〈0.05）. The coincidence rate of ultrasound in the diagnosis of liver injury and renal injury were 85.36% and 95.24% respectively while those of CT were 90.24% and 95.24% respectively（P〈0.05）. The characteristics of abdominal solid organ closed trauma were enlarged volume of the injured organs and inhomogeneous echo. CT findings were enlarged volume of injured organs, inhomogeneous density shadows. After enhanced scan, it become more obvious. Conclusion The accuracy rate of ultrasound in the diagnosis of abdominal liver and kidney injuries is similar to CT but CT is superior in the diagnosis of multiple organ injury and spleen injury.