Galanski M
Abt. Radiologie, Medizinische Hochschule Hannover, Carl-Neuberg-Strasse 1, 30625 Hannover.
Chirurg. 2006 Sep;77(9):800-14. doi: 10.1007/s00104-006-1226-z.
The integration of multislice CT (MSCT) in the imaging of emergency trauma has led to a paradigm shift in trauma management. In case of hemodynamically instable patients, initial imaging is limited to a small set of standardized radiographs. Computed tomography is the imaging modality of choice for further diagnostic work-up. Consequently it should be used at an early stage and in a less restricted manner for complete assessment of the pelvic injury and to determine therapeutic management. The MSCT allows full assessment of bone, parenchymal, and vascular injuries in a single examination in the shortest time possible. High-resolution 3D imaging provides additional options. There is increasing support for primary use of MSCT in critically ill patients due to the comprehensive imaging it allows while maintaining a fast scan time. The potential and limitations of diagnostic imaging in pelvic ring fracture and associated injuries are explained. Indications for vascular interventions in arterial bleeding are discussed.
多层螺旋CT(MSCT)在急诊创伤成像中的应用已引发创伤管理模式的转变。对于血流动力学不稳定的患者,初始成像仅限于一小部分标准化的X线片。计算机断层扫描是进一步诊断检查的首选成像方式。因此,应在早期以较少限制的方式使用它,以全面评估骨盆损伤并确定治疗方案。MSCT能够在最短时间内通过一次检查全面评估骨骼、实质器官和血管损伤。高分辨率三维成像提供了更多选择。由于MSCT在保持快速扫描时间的同时能够进行全面成像,越来越多的人支持在重症患者中首先使用它。文中解释了盆腔环骨折及相关损伤的诊断成像的潜力和局限性。讨论了动脉出血时血管介入的指征。