摘要
目的通过外伤性脾破裂CT、DSA影像的对照分析,探讨诊断急性脾破裂快捷有效的检查方法。方法57例外伤性脾破裂均行CT、DSA检查,并作介入性脾动脉栓塞治疗及随访复查。结果CT在脾实质的裂伤、脾内血肿、脾包膜下血肿、脾包膜破裂及腹内脏器合并伤具有很高的敏感性和准确性,尤其在脾局限性裂伤的显示上明显优于DSA,两者间差异非常显著(χ2=10.71,P<0.005);DSA在脾实质内小片挫伤,尤其是弥漫性小片脾实质挫伤、脾内动脉瘤的部位和形态、介入治疗后栓塞部位的显示较CT更具优势,在脾内小片状挫伤的显示上优于CT,两者间差异非常显著(χ2=12.57,P<0.005)。结论CT与DSA在诊断中可以相互补充,相互印证,在CT确诊脾破裂后,患者生命体征较稳定时,尽量考虑作DSA检查,为可能的介入性栓塞治疗创造条件,降低手术治疗的并发症。
Objective To explore the better diagnostic method for acute splenic arteral injury through comparative analysis of CT and DSA. Methods Fifty-seven patients with acute splenic injury were examined by CT and DSA, treated with splenic arterial embelization and then undertook follow up. Results CT examination possessed higher sensitivity and accuracy than DSA in demonstrating splenic parenchymal laceration, intrasplenic hematoma, subcapsuler hematoma, rupture of splenic capsule and combinated injury of intra,abdominal organs, especially in localizing splenic laceration. And there was a high significant difference statistically between the two kinds of examination （X^2= 10.71, P 〈 0. 005）. DSA had advantages over CT in revealing fasciola contusion of splenic parenchyma, the site and appearance of intrasplenic aneurysms and manifestation of embelized region after interventional treatment. And there was also high significant difference statistically between them （X^2 = 12.57, P 〈 0.005）. Conclusions CT and DSA are complementary in the diagnosis of splenic injury. After CT confirmation of splenic injury and the patient vital signs being stable, DSA should be referred to as soon as possible for further detail information as well as for possible interventional embolization and reduction of surgical complications.
出处
《介入放射学杂志》
CSCD
2005年第6期576-579,共4页
Journal of Interventional Radiology
关键词
脾破裂
体层摄影术
X线计算机
数字减影血管造影术
Splenic injury
X-ray computed tomography
Digital subtraction angiography
Comparison
