MSCT在肾上腺闭合性损伤中的应用探讨

Study on Application of MSCT in the Adrenal Closed Injury

目的分析肾上腺闭合性损伤MSCT表现特征,以提高诊断的准确率。方法回顾性分析2013年7月—2016年12月该院收治并经临床随访证实的31例闭合性肾上腺损伤的临床及MSCT资料。结果全部患者均在外伤后2 d内行MSCT检查,除2例复合伤患者死亡外,余均有2次以上的MSCT随访资料,随访时间3周~7个月。右侧肾上腺损伤26例,左侧4例,双侧1例。MSCT平扫表现为肾上腺弥漫性或局灶性肿胀、肾上腺区类圆形、长椭圆形等高密度影、略低密度影;可伴肾上隙弧形受压;病灶周围脂肪间隙模糊、浑浊,密度增高、伴线条影;多伴同侧膈肌脚肿胀及胸腹部脏器的损伤;均伴胸腔积液、肋骨骨折及横突骨折。CT随访观察可见病灶逐渐缩小,密度减低,肾上腺渐变为正常大小。结论肾上腺闭合性损伤具有一定特征性的MSCT表现,结合创伤史及MSCT随访,可明确诊断。

Objective To analyze the MSCT manifestation features of adrenal closed injury to improve the diagnosis accuracy. Methods The clinical data and MSCT data of 31 cases of patients with adrenal closed injury admitted and treated in our hospital from July 2013 to December 2016 were reviewed. Results All patients underwent the MSCT examination in 2 d after injury, and 2 cases died due to compound injury, the others had MSCT follow-up data more than two times, and the follow-up time was 3 weeks to 7 months, and there were 26 cases with right adrenal injury, and 4 cases with left adrenal injury, and 1 case with bilateral adrenal injury, and the MSCT plain scanning was featured as the diffuse or focal swelling of the adrenal gland, adrenal area circular, oblong high density shadow, slightly low density shadow, with adrenal gas pressured in arc shape, and the lesion fat space around esophagus was fuzzy, turbid, accompanied by line shadow, most lesions were with the diagram swelling and thoracic abdominal organs injuries, all were associated with pleural effusion, rib fractures and transverse fracture. CT showed the lesions gradually decreased, the density decreased and the adrenal was gradually reduced to normal size. Conclusion Closed adrenal injury has a certain characteristic MSCT features, which can be diagnosed clearly with the history of trauma and follow-up results of MSCT.