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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。
Objective: To evaluate the value of 64-slice spiral CT in the diagnosis of chest trauma. Methods: From January 2006 to March 2008, 81 cases of thoracic trauma were treated in our hospital. All patients underwent 64-slice spiral CT in 10 min to 5 h after injury. Among them, 58 patients underwent CR or The bedside CR examination was performed on a GE LightSpeed 64-slice CT scanner with a layer thickness of 0.625 mm and a pitch of 0.984: 1. Results: Of the 81 cases, there were 72 cases of rib fracture, 65 cases of pulmonary contusion and laceration, 36 cases of pneumothorax, 53 cases of hemothorax, 31 cases of hemothorax, 12 cases of clavicle fracture, 13 cases of scapular fracture, 18 cases of subcutaneous and mediastinal gas accumulation, Right diaphragm rupture in 2 cases. Non-dislocated and avulsed ribs and costal cartilage fractures often show poor CR in patients who have undergone CR examinations at the same time, and are clearly shown on 64-slice spiral CT multiplanar or 3D reconstructed images. Conclusion: The multi-slice and three-dimensional reconstruction of 64-slice spiral CT is superior to x-ray in the detection of various pathological changes of chest trauma, which is of great guiding significance for the formulation of clinical emergency plan.