Accuracy of chest radiography versus chest computed tomography in hemodynamically stable patients with blunt chest trauma

Objective：Thoracic injuries are responsible for 25% of deaths of blunt traumas.Chest X-ray （CXR） is the first diagnostic method in patients with blunt trauma.The aim of this study was to detect the accuracy of CXR versus chest computed tomograpgy （CT） in hemodynamically stable patients with blunt chest trauma.Methods：Study was conducted at the emergency department of S ina Hospital from March 2011 to March 2012.Hemodynamically stable patients with at least 16 years of age who had blunt chest trauma were included.All patients underwent the same diagnostic protocol which consisted of physical examination,CXR and CT scan respectively.Results：Two hundreds patients （84% male and 16% female） were included with a mean age of（37.9±13.7） years.Rib fracture was the most common finding of CXR （12.5%） and CT scan （25.5%）.The sensitivity of CXR for hemothorax,thoracolumbar vertebra fractures and rib fractures were 20%,49% and 49%,respectively.Pneumothorax,foreign body,emphysema,pulmonary contusion,liver hematoma and sternum fracture were not diagnosed with CXR alone.Conclusion：Applying CT scan as the first-line diagnostic modality in hemodynamically stable patients with blunt chest trauma can detect pathologies which may change management and outcome.

小儿脊椎损伤中影像学检查诊断价值探讨(附46例分析)

目的 :评价小脊椎损伤中影像学检查的价值。材料与方法 :4 6例脊椎损伤病例均进行X线平片 ,CT扫描。椎管受累者 4例进行MRI检查。结果 :X线平片 ,CT证实椎体骨折 17例。颈椎 4例 (寰椎侧块 2例 ,寰椎前结节 1例。C3 椎体左侧横突骨折 1例 )。胸腰椎骨折 13例。其中爆裂型T12 L1骨折 3例 ,L5椎体爆裂型骨折 1例。前者椎管内有多个骨碎片 ,硬膜囊疝形成。椎管指数 2～ 3。后者损伤累及脊椎前、中柱 ,椎管形态异常。②单纯椎体压缩性骨折 9例。③ 4 0例检出腰椎间盘病。其中 36例腰椎间盘膨出症 ,4例为腰椎间盘突出症。④ 4例疑似脊髓、神经损伤又进行了MRI检查。均显示脊髓信号异常。 2例脊髓圆锥受压 ,硬膜囊疝形成。 1例T12 L1脊髓血肿 ,1例脊髓水肿、挫伤。结论 :在小儿脊椎损伤中 ,影像学检查为临床诊断、治疗提供了重要的、有价值的依据。