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钝性胰腺创伤的影像学检查

Imaging of blunt pancreatic trauma.

作者信息

Rekhi Satinder, Anderson Stephan W, Rhea James T, Soto Jorge A

机构信息

Department of Radiology, Boston University Medical Center, Boston, MA, USA.

出版信息

Emerg Radiol. 2010 Jan;17(1):13-9. doi: 10.1007/s10140-009-0811-0. Epub 2009 Apr 25.

Abstract

Blunt pancreatic trauma is an exceedingly rare but life-threatening injury with significant mortality. Computed tomography (CT) is commonly employed as the initial imaging modality in blunt trauma patients and affords a timely diagnosis of pancreatic trauma. The CT findings of pancreatic trauma can be broadly categorized as direct signs, such as a pancreatic laceration, which tend to be specific but lack sensitivity and indirect signs, such as peripancreatic fluid, which tend to be sensitive but lack specificity. In patients with equivocal CT findings or ongoing clinical suspicion of pancreatic trauma, magnetic resonance cholangiopancreatography (MRCP) may be employed for further evaluation. The integrity of the main pancreatic duct is of crucial importance, and though injury of the duct may be strongly suggested upon initial CT, MRCP provides clear delineation of the duct and any potential injuries. This article aims to review and illustrate the CT and magnetic resonance imaging findings of blunt pancreatic trauma and delineate the integration of these modalities into the appropriate imaging triage of severely injured blunt trauma patients.

摘要

钝性胰腺创伤极为罕见,但却是一种危及生命的损伤,死亡率很高。计算机断层扫描(CT)通常作为钝性创伤患者的初始影像学检查方法,能够及时诊断胰腺创伤。胰腺创伤的CT表现大致可分为直接征象,如胰腺裂伤,这类征象往往具有特异性,但敏感性不足;以及间接征象,如胰周积液,这类征象往往敏感性较高,但缺乏特异性。对于CT表现不明确或临床仍怀疑有胰腺创伤的患者,可采用磁共振胰胆管造影(MRCP)进行进一步评估。主胰管的完整性至关重要,虽然在初次CT检查时可能强烈提示存在胰管损伤,但MRCP能清晰显示胰管及其任何潜在损伤。本文旨在回顾并阐述钝性胰腺创伤的CT和磁共振成像表现,并说明如何将这些检查方法整合到对严重钝性创伤患者进行适当的影像学分流中。

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