多层螺旋CT一站式检查在胸腹部复合地震伤中的应用
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摘要
目的探讨多层螺旋CT(MSCT)一站式检查在胸腹部地震复合伤中的临床应用价值。方法同时行数字化X线摄影(DR)和MSCT检查的胸腹部地震复合伤患者共162例,比较两种检查方法的检查时间、辐射剂量和诊断价值,以优化检查流程并优选检查方法。结果胸腹部地震复合伤影像学检查,MSCT耗时(5±2)min,DR耗时(10±3)min(P<0.001)。胸腹部DR投照总吸收剂量约为(2.4±1.3)mSv,而MSCT的吸收剂量约为(6.4±1.7)mSv,高于DR投照(P<0.001)。对明显的锁骨、肋骨、胸骨、胸椎、腰椎以及骨盆骨折,MSCT和DR均可较好显示;对于肝、胰、脾等软组织脏器的创伤,DR不能显示。MSCT对胸腹部地震复合伤骨折检出的敏感性(98%)和特异性(97%)高于DR(74%,67%)。结论 MSCT一站式检查节约检查时间并且诊断可靠,因此可作为群体应急事件中复合伤的首选检查方法。
Objective To assess the clinical value of multi-slice CT in one-stop examination of thoracic and abdominal injuries in earthquake victims.Methods DR and multi-slice CT examination were performed in 162 earthquake victims with thoracic and abdominal injuries.Optimal processes and preferred modalities were identified through comparisons of examination time,radiation dose and diagnostic value between the two methods.Results The multi-slice CT took(5±2) min,shorter than that of DR(10±3) min(P<0.001).The radiation dose of multi-slice CT(6.4±1.7) mSv was higher than that of DR(2.4±1.3) mSv(P<0.001).Both methods were able to detect bone fracture(clavicle,rib,sternum,thoracic spine,lumbar and pelvic).However,soft-tissue organ trauma,such as liver,pancreas and spleen could not be detected by DR.Multi-slice CT had significantly higher sensitivity (98%) and specificity(97%) in detecting thoracic and abdominal injuries than DR(74%,67%).Conclusion Multi-slice CT one-stop examination is a preferred method for detecting combined injuries in emergency events,as it can save examination time and obtain reliable diagnostic information.
Objective To assess the clinical value of multi-slice CT in one-stop examination of thoracic and abdominal injuries in earthquake victims.Methods DR and multi-slice CT examination were performed in 162 earthquake victims with thoracic and abdominal injuries.Optimal processes and preferred modalities were identified through comparisons of examination time,radiation dose and diagnostic value between the two methods.Results The multi-slice CT took(5±2) min,shorter than that of DR(10±3) min(P<0.001).The radiation dose of multi-slice CT(6.4±1.7) mSv was higher than that of DR(2.4±1.3) mSv(P<0.001).Both methods were able to detect bone fracture(clavicle,rib,sternum,thoracic spine,lumbar and pelvic).However,soft-tissue organ trauma,such as liver,pancreas and spleen could not be detected by DR.Multi-slice CT had significantly higher sensitivity (98%) and specificity(97%) in detecting thoracic and abdominal injuries than DR(74%,67%).Conclusion Multi-slice CT one-stop examination is a preferred method for detecting combined injuries in emergency events,as it can save examination time and obtain reliable diagnostic information.
引文
1张连阳.努力提高多发伤的救治速度.中华创伤学杂志,2007;23(4):241-243.
2罗凤鸣,刘春涛.地震中的肺及胸部损伤.中国呼吸与危重监护杂志,2008;7(4):311-312.
3Sirmali M,Turut H,Topcu S,et al.A comprehensive analysisof traumatic rib fractures:morbidity,mortality andmanagement.Eur J Cardiothorac Surg,2003;24(1):133-138.
4Ghodsi SM,Zargar M,Khaji A,et al.Chest injury in victims ofBam earthquake.Chin J Traumatol,2006;9(6):345-348.
5Ozdogan S,Hocaoglu A,Caglayan B,et al.Thorax and lunginjuries arising from the two earthquakes in Turkey in1999.Chest,2001;120(4):1163-1166.
6Lomoschitz FM,Eisenhuber E,Linnau KF,et al.Imaging ofchest trauma:radiological patterns of injury and diagnosticalgorithms.Eur J Radiol,2003;48(1):61-70.
7Vialle LR,Vialle E.Thoracic spine fractures.Injury,2005;36(Suppl2):B65-72.
8Linsenmaier U,Brunner U,Sch ning A,et al.Classification ofcalcaneal fractures by spiral computed tomography:implicationsfor surgical treatment.Eur Radiol,2003;13(10):2315-2322.
9Medina SL.Three-dimensional CT maximum intensityprojections of the calvaria:a new approach for diagnosis ofcraniosynostosis and fractures.AJNR Am J Neuroradiol,2000;21(10):1951-1954.
2罗凤鸣,刘春涛.地震中的肺及胸部损伤.中国呼吸与危重监护杂志,2008;7(4):311-312.
3Sirmali M,Turut H,Topcu S,et al.A comprehensive analysisof traumatic rib fractures:morbidity,mortality andmanagement.Eur J Cardiothorac Surg,2003;24(1):133-138.
4Ghodsi SM,Zargar M,Khaji A,et al.Chest injury in victims ofBam earthquake.Chin J Traumatol,2006;9(6):345-348.
5Ozdogan S,Hocaoglu A,Caglayan B,et al.Thorax and lunginjuries arising from the two earthquakes in Turkey in1999.Chest,2001;120(4):1163-1166.
6Lomoschitz FM,Eisenhuber E,Linnau KF,et al.Imaging ofchest trauma:radiological patterns of injury and diagnosticalgorithms.Eur J Radiol,2003;48(1):61-70.
7Vialle LR,Vialle E.Thoracic spine fractures.Injury,2005;36(Suppl2):B65-72.
8Linsenmaier U,Brunner U,Sch ning A,et al.Classification ofcalcaneal fractures by spiral computed tomography:implicationsfor surgical treatment.Eur Radiol,2003;13(10):2315-2322.
9Medina SL.Three-dimensional CT maximum intensityprojections of the calvaria:a new approach for diagnosis ofcraniosynostosis and fractures.AJNR Am J Neuroradiol,2000;21(10):1951-1954.
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