Yu Jinxing, Fulcher Ann S, Turner Mary A, Cockrell Charles, Halvorsen Robert A
Department of Radiology, Virginia Commonwealth University Health System, Richmond, 23298-0615, USA.
Abdom Imaging. 2011 Feb;36(1):50-61. doi: 10.1007/s00261-009-9593-9.
Multidetector computed tomography (MDCT) has emerged as the imaging modality of choice for evaluating the abdomen and pelvis in trauma patients. MDCT readily detects injury of the solid organs as well as direct and indirect features of bowel and/or mesenteric injury-an important advance given that unrecognized bowel and mesenteric injuries may result in high morbidity and mortality. Nonetheless, challenges persist in the interpretation of abdominal and pelvic CT images in trauma patients. Difficulty in interpretation may result from lack of familiarity with or misunderstanding of CT features of bowel and/or mesenteric injury. Moreover, due to major technical advances afforded by MDCT, new CT features of bowel and/or mesenteric injuries have been recognized. Beading and termination of mesenteric vessels indicating surgically important mesenteric injury is an example of one of these new features. MDCT also allows for the detection of small or trace amounts of isolated intraperitoneal fluid in trauma patients, although the clinical management of these patients is still controversial. This pictorial essay illustrates the spectrum of typical, atypical, and newly reported MDCT features of bowel and mesenteric injuries due to blunt trauma. The features that help to differentiate these injuries from pitfalls are emphasized in these proven cases.
多排螺旋计算机断层扫描（MDCT）已成为评估创伤患者腹部和骨盆的首选成像方式。MDCT能够轻易检测出实体器官的损伤以及肠管和/或肠系膜损伤的直接和间接特征，鉴于未被识别的肠管和肠系膜损伤可能导致高发病率和死亡率，这是一项重要进展。尽管如此，创伤患者腹部和盆腔CT图像的解读仍存在挑战。解读困难可能源于对肠管和/或肠系膜损伤的CT特征不熟悉或误解。此外，由于MDCT带来的重大技术进步，已识别出肠管和/或肠系膜损伤的新CT特征。肠系膜血管的串珠样改变和中断提示具有手术重要性的肠系膜损伤就是这些新特征之一。MDCT还能检测出创伤患者少量或微量的孤立性腹腔内积液，尽管对这些患者的临床处理仍存在争议。这篇图文并茂的文章阐述了钝性创伤所致肠管和肠系膜损伤的典型、非典型及新报道的MDCT特征谱。在这些已证实的病例中，强调了有助于将这些损伤与陷阱相鉴别的特征。
