创伤性脾脏损伤72例CT平扫分析

Analysis of Plain CT Scan of the Spleen Injuries

目的 旨在进一步提高脾脏损伤的CT诊断水平。方法 采用CT平扫对 72例脾脏损伤患者进行中上腹部检查 ,层厚 10mm ,层间距 10mm ,部分病例作局部 3～ 5mm薄层扫描。结果 脾脏表面损伤合并腹腔积血 4例 ,脾脏裂伤合并腹腔积血 1例 ,脾内血肿及延迟性脾损伤 4例 ,脾脏挫裂伤 (脾碎裂 )合并腹腔积血 5 0例 ,脾脏包膜下血肿合并腹腔积血 10例 ,脾脏损伤合并肝脏损伤及左膈疝各 1例 ,误诊 1例。结论 腹部CT平扫在诊断早期及延迟性脾脏损伤有其独特优势 ,而腹腔积血则在脾脏损伤诊断有重要的意义。

Objective To improve the diagnostic level of the spleen injuries. Methods The superior and middle abdominal plain CT scan was performed in 72 cases of the spleen injuries,with 10mm section thickness and 10mm table incrementation.Parts of cases were scaned with a magnified section thickness ranging from 3 to 5mm. Results There were spleen superficial injuries with hemoperitoneum in 4 cases,spleen cleft injury with hemoperitoneum in 1 case,spleen hematom with the delayed spleen injuries in 4 cases,spleen contused and cleft injury (the spleen fragmentation) with hemoperitoneum in 50 cases,hematom under the spleen envelope with hemoperitoneum in 10 cases,spleen with liver injuries or the left diaphragmatic hernia in 1 case respectively,and misdiagnosis in 1 case. Conclusion The abdominal plain CT scan is of unique value in diagnosing the early and delayed spleen injuries,while hemoperitoneum has great significance in it.