肾损伤的CT诊断(附52例分析)

CT diagnosis of posttraumatic renal injuries:analysis in 52cases

目的分析肾损伤的CT表现并评价其临床意义。方法52例肾损伤患者(车祸30例,高处坠落15例,其他7例)于创伤后24小时至1周内均经CT平扫检查。参照Kawashima等人的分类法,将本组患者肾损伤CT表现分为4类。结果52例肾损伤依据其CT表现分为如下4大类型:1型(20例)表现为较小的肾挫伤,撕裂伤,包膜下血肿,以及微小的皮质梗塞;2型(19例)表现为较大的肾撕裂伤且向髓质延伸,或伴有结合系统受累;3型(10例)表现为重笃肾损伤包括肾碎裂和肾蒂血管损伤;4型(3例)表现为输尿管肾盂连接处损伤。结论CT平扫能较准确的证实肾损伤的范围和程度。肾损伤的CT表现与临床信息相结合对制定最佳治疗方案极为重要。

Objective To analyze the CT findings of posttra umatic renal injuries and to assess t heir significance in the clinical pr ac-tice.Methods Fifty -two patients with suspected r enal injury which included 30traffi c accidents,15high positon droppin g and 7other trauma underwent CT plain scans with in 24h to one week after the trauma.Ac cording to the classifcation for CT f indings of renal injuries recommended by kawashima et al,the r enal injuries seen in the study were c lassified into four large categorie s.Results The CT findings of renal injuries in all patients can be classified into four large types:ty pe 1in 20cases presented minor corti cal contusion,subcapsular hematoma,minor laceration with lim ited perinephric hematoma,and smal l cortical infarct;type 2in 19cases presented major renal lac-erations extending to the medulla wi th or without involvement of the coll ecting system;type 3in 10cases presented catastrophic renal in-juries including fragmentation of t he kidney and renal pedicle vascular injuries;and type 4in 3cases presen ted uretero -pelvic junction injuries.conclusion CT plain scans can accurately reveal the extent and the degree of posttrau matic renal injury.Integration of t he CT findings of renal injury with clinic al information is important to devel oping an optimal treatment plan.[