摘要
目的 确定闭合性腹膜内型膀胱破裂的CT诊断价值。方法 对 9例闭合性腹膜内型膀胱破裂的CT资料和临床处理进行回顾性分析。结果 所有 9例腹膜内型膀胱破裂 ,CT均明确诊断。CT显示腹膜腔内低密度液体积聚 9例 ,其CT值比血液低 ,主要分布在膀胱侧隐窝、盆腔陷凹、结肠旁沟、肝脾周围和肠袢内。膀胱壁局部缺损 3例 ,泪滴状变形 2例 ;其他支持膀胱破裂的CT征象包括 :膀胱充盈不良 8例 ,膀胱壁挫伤 4例 ,膀胱内血凝块 6例。结论 在创伤情况下 ,腹膜腔内出现CT值比血液小的低密度液体积聚 ,强烈提示尿外渗 ,根据尿外渗的分布范围 ,CT还可以区别腹膜内和腹膜外型膀胱破裂。CT有时还可以观察到膀胱破裂的准确位置 。
Objective To evaluate CT examination in the diagnosis of intraperitoneal bladder rupture (IPBR) caused by blunt abdominal trauma. Methods All CT and clinical data of 9 patients with IPBR were reviewed retrospectively. Results IPBR was detected on CT scans in all 9 patients. CT findings of IPBR included low attenuation free intraperitoneal fluid collections in the lateral paravesical fossae, the pericolic space, the cul de sac of the pelvis, Morison′s pouch ,the perihepatic space,the perisplenic space, and interspace of bowel loops in 9 cases with a lower CT density compared with pure blood. The disruption of the bladder wall was located by CT scan in 5 cases: high attenuation bladder wall with focal defect in 3 cases and a tear drop like deformity of the bladder in 2 cases. Other CT findings supporting the diagnosis of IPBR included an underfilled bladder in 8 cases, bladder contusion in 4 cases, and blood clots within the bladder in 6 cases. Conclusion The presence of intraperitoneal fluid with a CT density less than that of pure blood strongly suggests extravasated urine in the trauma. Intraperitoneal and extraperitoneal rupture can be distinguished based on location of extravasated urine seen on CT scans.The precise localization of the ruptured bladder wall may be demonstrated by CT scan, which is valuable for surgical treatment.
出处
《中华放射学杂志》
CAS
CSCD
北大核心
2000年第9期630-632,共3页
Chinese Journal of Radiology
