CAJ | 학술논문

目的：探讨外伤性脾破裂CT平扫征象，提高CT平扫对外伤性脾破裂诊断准确率。方法回顾性分析本院2007年10月-2015年6月收治经手术证实的48例脾破裂CT平扫表现，以手术所见为金标准，由2名有经验的影像诊断医师以双盲法对螺旋CT征象系统性总结，采用Cochran Armitage趋势检验进行统计分析。确定P<0.05为差异有统计学意义。结果本组48例中脾实质增大、密度不均匀30例，脾外缘模糊、不连续40例，脾周少许—大量积液48例，脾邻近脏器损伤28例，表现为肝周积液、腹腔及肠间隙积液，左侧脾周肋骨骨折，左下肺创伤性湿肺，左侧胸腔积液，膈肌上抬。敏感性及特异度分别为，90%(43/48)、98%(47/48)。结论左上腹外伤史，脾脏CT平扫表现为脾实质增大、密度不均匀、外缘模糊、不连续、脾周少许—大量积液、肝周积液、腹腔及肠间隙积液，左侧肋骨骨折，左下肺创伤性湿肺，左侧胸腔积液，左膈肌上抬，均提示脾破裂可能，脾及脾边缘不完整，密度不均，为重要直接征象征，脾周积液为重要间接征象，可提高CT平扫诊断外伤性脾破裂准确率。
목적：탐토외상성비파렬CT평소정상，제고CT평소대외상성비파렬진단준학솔。방법회고성분석본원2007년10월-2015년6월수치경수술증실적48례비파렬CT평소표현，이수술소견위금표준，유2명유경험적영상진단의사이쌍맹법대라선CT정상계통성총결，채용Cochran Armitage추세검험진행통계분석。학정P<0.05위차이유통계학의의。결과본조48례중비실질증대、밀도불균균30례，비외연모호、불련속40례，비주소허—대량적액48례，비린근장기손상28례，표현위간주적액、복강급장간극적액，좌측비주륵골골절，좌하폐창상성습폐，좌측흉강적액，격기상태。민감성급특이도분별위，90%(43/48)、98%(47/48)。결론좌상복외상사，비장CT평소표현위비실질증대、밀도불균균、외연모호、불련속、비주소허—대량적액、간주적액、복강급장간극적액，좌측륵골골절，좌하폐창상성습폐，좌측흉강적액，좌격기상태，균제시비파렬가능，비급비변연불완정，밀도불균，위중요직접정상정，비주적액위중요간접정상，가제고CT평소진단외상성비파렬준학솔。
Objective To investigate the CT appearances of traumatic splenic rupture, and to improve the diagnostic accuracy of CT scan in the diagnosis of traumatic splenic rupture.Methods A retrospective analysis in our hospital from October 2007 to 2015 June were conifrmed by operation of 48 cases of splenic rupture performance of CT scan and surgery is seen as the gold standard, by two experienced radiologists in a double blind method of spiral CT signs of systemic summary, the Cochran Armitage trend test was used for statistical analysis. <0.05 P was statistically significant. Results This group of 48 cases of splenic parenchyma increases, density is uniform in 30 cases, spleen blurry edge, not forty consecutive cases, spleen Zhou Shaoxu, 48 cases of massive effusion, spleen adjacent organ injury in 28 cases, liver week effusion, abdominal cavity and intestinal clearance effusion and left perisplenic rib fractures, left inferior pulmonary traumatic wet lung, left pleural effusion, diaphragmatic lift. Sensitivity and speciifcity were 90% (43/48), 98% (47/48).Conclusion Left upper abdominal trauma history, sweep spleen CT performance enlargement of the spleen parenchyma, uneven density, blurry edge, discontinuity and spleen week a little - large effusion, liver week effusion, abdominal cavity and intestinal clearance effusion, left rib fractures, left inferior pulmonary traumatic wet lung, left pleural effusion, left diaphragmatic elevation suggest that the spleen rupture, spleen and splenic marginal incomplete, uneven density, important direct sign symbol, perisplenic lfuid important indirect signs, improve CT scan diagnosis of traumatic splenic rupture accuracy.