摘要
目的:探讨X线平片和CT对胸部创伤的临床诊断价值。方法:总结分析386例严重胸部创伤患者的影像检查,以临床诊断和影像复查为金标准,对X线平片与CT对胸部创伤的诊断价值进行对比分析。结果:386例中,胸壁骨折328例,气胸82例,血胸98例,血气胸136例,肺挫伤265例,肺撕裂伤150例,肺不张75例,支气管损伤11例,胸主动脉损伤8例,纵隔血肿9例,心包心脏损伤12例,膈肌损伤17例,创伤后呼吸窘迫综合症(ARDS)52例。X线平片分别漏诊22,22,20,22,133,72,36,4,6,9,11,17,28例,CT除17例肋骨骨折外均准确诊断。结论:X线和CT联合检查能够明确胸部创伤病变的部位、性质、程度,为临床提供可靠诊断,可监测病情演变,评价治疗效果。
Objective：To discuss the value of radiography and CT in the diagnosis of thoracic injury.Methods：The imaging features of 386 cases with severe thoracic injury were analyzed.Taking clinical diagnosis and results of follow-up imaging examination as the golden standard,the value of radiography and CT in the diagnosis of thoracic injury were evaluated and compared.Results：Of the 386 cases,there were fracture of the chest wall（328 cases）,pneumothorax（82 cases）,hemothorax（98 cases）,hemo-pneumothorax（136 cases）,pulmonary contusion（265 cases）,lung laceration（150 cases）,atelectasis（75 cases）,bronchial injury（11 cases）,thoracic aorta injury（8 cases）,mediastinal hematoma（9 cases）,pericardium/heart injury（12 cases）,diaphragm injury（17 cases）,post-traumatic ARDS（52 cases）.Mis-diagnosis by chest radiography were found in 22,22,20,22,133,72,36,4,6,9,11,17,28 respectively.Apart from 17 cases with rib fracture,all of the other injuries were diagnosed accurately by CT.Conclusion：The location,characteristics and degree of thoracic injuries could be reliably diagnosed by radiography in combination with CT,which is helpful in making accurate diagnosis,monitoring the course of trauma and evaluating the curative effect for clinical practice.
出处
《放射学实践》
北大核心
2009年第9期1012-1016,共5页
Radiologic Practice
作者简介
李长启（1966-），男，北京人，副主任医师，主要从事创伤和神经系统影像诊断工作。
