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磁共振成像在肾外伤中能发挥作用吗?

Is there a role for magnetic resonance imaging in renal trauma?

作者信息

Ku J H, Jeon Y S, Kim M E, Lee N K, Park Y H

机构信息

Department of Urology, Military Manpower Administration, Taejeon, Seoul, Korea.

出版信息

Int J Urol. 2001 Jun;8(6):261-7. doi: 10.1046/j.1442-2042.2001.00297.x.

DOI:10.1046/j.1442-2042.2001.00297.x
PMID:11389740
Abstract

BACKGROUND

Computed tomography (CT) has been the most informative imaging method in renal trauma. Despite the good sensitivity of magnetic resonance imaging (MRI) to the presence of hematoma, edema and ischemia, MRI has not been widely studied in patients with renal trauma. The present study was initiated to evaluate the role of MRI in patients with renal trauma.

METHODS

Between June 1998 and September 1999, CT and MRI were prospectively performed on 12 patients who suffered from renal trauma and the results reviewed.

RESULTS

The presence and size of perirenal hematoma could be detected by both CT and MRI. Magnetic resonance imaging could differentiate intrarenal hematoma from perirenal hematoma more accurately, and provided additional information about the hematoma as T1- and T2-weighted MRI were able to determine recent bleeding in the hematoma by regional differences in signal intensity. Magnetic resonance imaging clearly revealed renal fracture with non-viable fragment and detected focal renal laceration that was not detected on CT due to perirenal hematoma associated with renal infarction. However, although MRI had many advantages over CT, it had also major drawbacks, which were that it required longer imaging time and increased the cost.

CONCLUSIONS

Magnetic resonance imaging may be useful in renal trauma. However, it is suggested that MRI should be limited to carefully selected patients, such as those with severe renal injury or equivocal findings on CT.

摘要

背景

计算机断层扫描(CT)一直是肾外伤中信息量最大的成像方法。尽管磁共振成像(MRI)对血肿、水肿和缺血的存在具有良好的敏感性,但在肾外伤患者中,MRI尚未得到广泛研究。本研究旨在评估MRI在肾外伤患者中的作用。

方法

1998年6月至1999年9月期间,对12例肾外伤患者前瞻性地进行了CT和MRI检查,并对结果进行了回顾。

结果

CT和MRI均能检测到肾周血肿的存在和大小。磁共振成像能够更准确地区分内肾血肿和肾周血肿,并能提供有关血肿的更多信息,因为T1加权和T2加权MRI能够通过信号强度的区域差异确定血肿内近期出血情况。磁共振成像能清晰显示伴有无活力碎片的肾骨折,并能检测到因肾梗死伴发的肾周血肿而在CT上未被发现的局灶性肾裂伤。然而,尽管MRI相对于CT有许多优点,但也有主要缺点,即成像时间较长且费用增加。

结论

磁共振成像在肾外伤中可能有用。然而,建议MRI应限于精心挑选的患者,如那些肾损伤严重或CT检查结果不明确的患者。

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