Shanmuganathan Kathirkamanathan
Department of Radiology, University of Maryland Medical Center, 22 South Greene Street, Baltimore, MD 21201, USA.
Semin Ultrasound CT MR. 2004 Apr;25(2):180-204. doi: 10.1016/j.sult.2004.02.002.
CT is the imaging modality of choice to evaluate hemodynamically stable patients suffering blunt abdominal trauma. During the past five years, single-slice helical CT has been replaced by multidetector row CT (MDCT). This development has revolutionized cross-sectional imaging for blunt trauma patients. Volumetric imaging with helical CT has been a major factor supporting the nonoperative management of solid organ injury. Trauma centers in the United States are replacing single-slice helical CT scanners with state-of-the-art MDCT in suites proximate to the patient receiving area and with facilities for monitoring and maintaining physiologic support. The ability to obtain high-resolution images with MDCT during optimal contrast enhancement at unparalleled speed helps detect the presence and define the extent of injuries, and crucially, to diagnose hemorrhage and vascular injuries. This article describes our current imaging protocol with MDCT-16 (i.e., 16 detector MDCT), the spectrum of diagnostic findings seen in blunt abdominal injury, and the role of MDCT in the characterization of hemorrhage and planning injury management.
CT是评估钝性腹部创伤血流动力学稳定患者的首选成像方式。在过去五年中,单层螺旋CT已被多排探测器CT(MDCT)所取代。这一发展彻底改变了钝性创伤患者的横断面成像。螺旋CT的容积成像一直是支持实体器官损伤非手术治疗的主要因素。美国的创伤中心正在患者接收区域附近配备最先进的MDCT,并具备监测和维持生理支持的设施,以取代单层螺旋CT扫描仪。MDCT能够在最佳对比增强时以无与伦比的速度获得高分辨率图像,有助于检测损伤的存在并确定损伤程度,至关重要的是,能够诊断出血和血管损伤。本文描述了我们目前使用MDCT-16(即16探测器MDCT)的成像方案、钝性腹部损伤中所见的诊断结果范围,以及MDCT在出血特征描述和损伤处理规划中的作用。