64层螺旋CT对胸部创伤的诊断价值

目的:评价64层螺旋CT相对于CR片在胸部创伤诊断中的价值。方法:我院2006年1月～2008年3月收治81例胸部创伤,全部患者在伤后10min至5h进行了64层螺旋CT检查,其中58例在初次检查后12～38h内进行了CR或床旁CR检查,CT扫描采用GE LightSpeed 64层螺旋CT机,层厚0.625 mm,螺距为0.984:1。结果:81例中诊断肋骨骨折72例,肺挫裂伤65例,气胸36例,血胸53例,血气胸31例,锁骨骨折12例,肩胛骨骨折13例,皮下及纵隔积气18例,右横膈破裂2例。在同时进行过CR检查的患者中,非错位性及撕脱性肋骨、肋软骨骨折在CR上常显示不佳,而在64层螺旋CT多平面或三维重建图像上显示非常清晰。结论:64层螺旋CT多平面及三维重建对胸部创伤各种病变的检测明显优于x线平片,对临床急救计划的制定有重要的指导意义。

The Value of 64-slice MSCT in the Diagnosis of Chest Trauma

Objective:To evaluate the advantages of 64-slice multislice computed tomography (MSCT) in the diagnosis of tho- racic trauma compared with the CR films.Methods:81patients with thoracic trauma were selected as the object in the study,from Jan- uary 2006 to March 2008.The thoracic CT and CR imaging data were analyzed retrospectively.All patients underwent the CT examina- tion in 10 min-5 h after the injury,and 58 patients received CR examination after 12-38 hours.The main imaging equipment was GE LightSpeed 64-slice MSCT,helical thickness was 0.625 mm and pitch was 0.984:1.Results:With 64-slice MSCT,rib fracture was found in 72 cases,pulmonary contusion in 65 cases,pneumothorax in 36 cases,haemothorax in 53 cases,hemopneumothorax in 31 cases,frac- tures of collar bone in 12 cases,fractures of shoulder blade in 13 cases,cutaneous emphysema and pneumomediastinum in 18 cases,right rupture of diaphragm in 2 cases of 81 patients.The fib fractures without allotopia and avulsion fractures,costal cartilage fractures could not be observed clearly in the CR films.However,they were very distinct in multi-planar reconstruction (MPR) or three-dimensional re- construction of MSCT for the patients who receive both of the examination of CR and MSCT.Conclusion:For the detection of various injuries in the thoracic trauma,the MSCT with MPR and three-dimensional reconstructions is much better than the X-ray plain films and ordinary spiral CT.It has great value in guiding clinic treatment.