【摘要】 目的探讨创伤性膈损伤的多层螺旋CT(MSCT)表现特征及诊断价值。方法回顾性分析笔者医院创伤性膈损伤患者33例,其中男性28例,女性5例,患者年龄1～76岁,33例均行MSCT检查且行冠、矢状位多平面重建(MPR)处理,分析患者临床资料与MSCT表现特征及诊断价值,影像学表现包括膈肌连续性中断征、膈肌增厚征、项圈征、面包征及膈疝部位及内容物等。结果 33例中,2例为单纯挫伤,31例为钝性损伤(左侧26例,右侧5例),膈疝内容物分别为胃或含液气肠袢(左侧25例,右侧1例)、肝脏(仅右侧3例)及腹腔脂肪(左侧16例,右侧2例);MSCT提示膈肌异常的敏感度为100%,21例(67.7%)可见膈肌连续性中断征,10例(32.2%)可见膈肌增厚征,项圈征与面包征各5例(16.1%)。与横断面相比,MPR能更好地显示膈肌连续性中断征(P<0.05)。结论 MSCT检查对诊断创伤性膈损伤有重要价值,尤其是MPR技术对诊断有很大帮助。更多还原

【Abstract】 Objective To determine the usefulness of multi-slice CT(MSCT) with multiple planar reconstruction(MPR) images in the diagnosis of traumatic diaphragm injuries(TDIs).Methods Thirty three patients of TDIs were reviewed retrospectively in this study,including 28 men and 5 women,aged from 1~76 years.Thirty three cases respectively underwent MSCT examinations.Sagittal and coronal MPRs were performed in all cases.The clinical data and MSCT appearances(such as the diaphragmatic discontinuity sign,the collar sign,the bread sign,and intra-thoracic location of herniated abdominal contents) were analyzed.Results Of 33 cases,2 cases were simple contusion,31 cases were blunt trauma injuries(left 26 cases,right 5 cases),The herniation intruding into the thoracic cavity consisted mainly of stomach or fluid gas bowel loops(left 25 cases,right 1 case),liver(only right 3 cases) and abdominal fat(left 16 cases,right 2 cases).The sensitivity of MSCT detecting the abnormality of the diaphragm was 100%.On MSCT images,21 cases(67.7%) showed diaphragmatic discontinuity sign,10 cases(32.2%) showed diaphragm thickening sign,and collar sign and bread sign were seen in 5 cases(16.1%) respectively.Compared with transverse CT scan,MPRs performed better for demonstrating the diaphragmatic discontinuity sign(19 cases vs 8 cases,P<0.05.Conclusion MSCT examinations are useful in the diagnosis of TDIs,especially when MSCT sagittal and coronal MPR images are obtained.更多还原