Bodanapally Uttam K, Shanmuganathan Kathirkamanathan, Mirvis Stuart E, Sliker Clint W, Fleiter Thorsten R, Sarada Kamal, Miller Lisa A, Stein Deborah M, Alexander Melvin
Department of Diagnostic Radiology, University of Maryland School of Medicine, 22 S Greene St., Baltimore, MD 21201, USA.
Eur Radiol. 2009 Aug;19(8):1875-81. doi: 10.1007/s00330-009-1367-9. Epub 2009 Mar 31.
The purpose of the study was to determine the diagnostic sensitivity and specificity of multidetector CT (MDCT) in detection of diaphragmatic injury following penetrating trauma. Chest and abdominal CT examinations performed preoperatively in 136 patients after penetrating trauma to the torso with injury trajectory in close proximity to the diaphragm were reviewed by radiologists unaware of surgical findings. Signs associated with diaphragmatic injuries in penetrating trauma were noted. These signs were correlated with surgical diagnoses, and their sensitivity and specificity in assisting the diagnosis were calculated. CT confirmed diaphragmatic injury in 41 of 47 injuries (sensitivity, 87.2%), and an intact diaphragm in 71 of 98 patients (specificity, 72.4%). The overall accuracy of MDCT was 77%. The most accurate sign helping the diagnosis was contiguous injury on either side of the diaphragm in single-entry penetrating trauma (sensitivity, 88%; specificity, 82%). Thus MDCT has high sensitivity and good specificity in detecting penetrating diaphragmatic injuries.
本研究的目的是确定多排螺旋CT（MDCT）在检测穿透性创伤后膈肌损伤中的诊断敏感性和特异性。对136例躯干穿透性创伤患者术前进行的胸部和腹部CT检查进行回顾，这些患者的损伤轨迹紧邻膈肌，由不了解手术结果的放射科医生进行阅片。记录穿透性创伤中与膈肌损伤相关的征象。将这些征象与手术诊断进行关联，并计算其在辅助诊断中的敏感性和特异性。CT在47例损伤中的41例中确诊为膈肌损伤（敏感性为87.2%），在98例患者中的71例中确诊膈肌完整（特异性为72.4%）。MDCT的总体准确率为77%。有助于诊断的最准确征象是单入口穿透性创伤中膈肌两侧的连续性损伤（敏感性为88%；特异性为82%）。因此，MDCT在检测穿透性膈肌损伤方面具有高敏感性和良好的特异性。
