Department of Radiology, Vancouver General Hospital, University of British Columbia, Vancouver, BC, Canada.
Radiographics. 2011 Jul-Aug;31(4):E101-15. doi: 10.1148/rg.314095177.
Cardiac injury due to blunt or penetrating chest trauma is common and is associated with significant morbidity and mortality. Understanding the mechanisms, types, and complications of cardiac injuries and the roles of various imaging modalities in characterizing them is important for appropriate diagnosis and treatment. These injuries have not been well documented at imaging, but there are now fast and accurate methods for evaluating the heart and associated mediastinal structures. The authors review the broad spectrum of injuries that can result from blunt or penetrating trauma to the chest, as well as the imaging modalities commonly used in the acute trauma setting for evaluation of the heart and mediastinal structures. A pictorial review of both common and, to date, rarely documented cardiac injuries imaged with a variety of modalities is also presented. While many imaging modalities are available, the authors demonstrate the value of multidetector computed tomography (CT) for the initial evaluation of patients with blunt or penetrating chest trauma. With the advent of multidetector CT, imaging of cardiac injury has increased and accurate identification of these rare but potentially lethal injuries has become paramount for improving survival. Selection of the most appropriate modality for evaluation and recognition of the imaging findings in cardiac injuries in the acute trauma setting is important to expedite treatment and improve survival.
由于钝性或穿透性胸部创伤导致的心脏损伤很常见，并且与显著的发病率和死亡率相关。了解心脏损伤的机制、类型和并发症，以及各种成像方式在其特征描述中的作用，对于正确的诊断和治疗至关重要。这些损伤在影像学上尚未得到很好的记录，但现在有快速准确的方法来评估心脏和相关的纵隔结构。作者回顾了钝性或穿透性胸部创伤可能导致的广泛的损伤类型，以及在急性创伤情况下常用于评估心脏和纵隔结构的成像方式。还对各种方式成像的常见和迄今为止很少记录的心脏损伤进行了图片回顾。虽然有许多成像方式可供选择，但作者展示了多排 CT（MDCT）在评估钝性或穿透性胸部创伤患者中的初始评估中的价值。随着多排 CT 的出现，心脏损伤的成像增加了，准确识别这些罕见但潜在致命的损伤对于提高生存率变得至关重要。在急性创伤情况下，选择最适合评估和识别心脏损伤的成像方式对于加快治疗和提高生存率非常重要。
