摘要
目的提高胸外伤CT表现的认识,并分析CT表现与临床严重程度的关系。方法回顾性分析128例胸外伤患者的X线胸片与胸部CT资料,按损伤程度的叶段分布、出血点、血气胸的量分为轻型与重型,并与临床严重程度及预后影像表现比较分析。结果CT轻型表现为肺内磨玻璃样影或合并少量斑片状影,分布于3个叶段以内,共65例,CT重型表现为肺内磨玻璃样影内合并点状、结节状出血高密度影,分布于3个叶段以上至双肺,共53例,均见气胸、积液,另10例为大量胸腔积液肺实变。临床分类轻度58例,重度70例,CT分类与临床分类一致性比较Kappa值为0.825,P<0.005,出院复查7.6%(5/65)CT轻度胸内病灶未完全吸收,57%(36/63)CT重度胸内病变未完全吸收,两组间差异显著(P<0.05)。结论胸部外伤后胸部CT表现与临床病情严重程度具有较好的一致性。
Objective To elevate the cognition of CT findings of thoracic trauma and to analyze the correlation between CT findings and clinical severity.Methods X-ray chest films and CT data of 128 patients with thoracic trauma were analyzed retrospectively.All the patients whose CT findings were divided into mild type and severe type according to the distribution of injured lobes and segments,hemorrhagic sites and the volume of hemothorax and pncumothorax,and compared with clinical severity and prognostic imaging findings.Results Mild -type CT findings were found in 65 cases who presented intrapulmonary ground shadows or associated with little patchy shadows but the lesions only located in three lobes or sigments,while severe type CT findings were found in 55 cases who presented intrapulmonary ground shadows associated with punctual,nodular hemorrhagic hyperdense shadows which were distributed in more than three lobes or segments or even in bilateral lungs associated with pneumothorax and pleural effusion.Remainder 10 cases had a number of pleural effusion and pulmonary consolidation.The clinical severity was also classified into mild type （n=58）and severe type （n=70）.There was better coincidence between CT typing and clinical classification （Kappa value=0.825）.When patients were dischaged from hospital,CT reexaminations showed that,non completely absorbed lesions in patients with mild type CT findings were 7.6%（5/65）,while those in patients with severe type CT findings were 57%（36/63）,there was significant difference（ P 〈 0.05）.Conclusion There is better coincidence between CT findings and clinical severity of thoracic trauma.
出处
《实用医学影像杂志》
2008年第5期288-290,共3页
Journal of Practical Medical Imaging
关键词
胸外伤
螺旋CT
临床严重度
预后
Thoracic trauma
Spiral CT
Clinical severity
Prognosis
