Ruf W, Friedl W, Weber G, Teller K
Abteilung für Diagnostische Radiologie, Chirurgischen Universitätsklinik Heidelberg.
Unfallchirurg. 1990 Mar;93(3):132-6.
In a comparative study based on the diagnosis of blunt abdominal trauma, the accuracy of ultrasound (US) proved inferior, with 82-91%, to that of diagnostic peritoneal lavage, with 97-100%. The sensitivity of US, i.e. the proportion of patients with blood in the abdomen who had an abnormal test result (positive sonography) was 94%. The reasons for this may be either patient-related (severe obesity, intestinal gas superposition) or examiner-related (differing previous experience). The specificity for correct elimination of abdominal lesions was 100%. When no intra-abdominal liquid was present none appeared in the US picture; however, 3-13% of cases where intra-abdominal liquid was present this was not revealed by US. If only a small amount of intra-abdominal liquid is demonstrated after blunt trauma, the adoption of a wait-and-see attitude is justified. In intensive care conditions US can be repeated several times if necessary. In this study US showed deterioration in these circumstances in 25%, and in 21% it must be expected that an operation will be necessary.
在一项基于钝性腹部创伤诊断的对比研究中，超声（US）的准确率为82 - 91%，被证明低于诊断性腹腔灌洗，后者的准确率为97 - 100%。超声的敏感性，即腹部有血且检查结果异常（超声检查阳性）的患者比例为94%。其原因可能与患者相关（严重肥胖、肠气叠加）或与检查者相关（既往经验不同）。正确排除腹部病变的特异性为100%。当腹腔内无液体时，超声图像中也不会出现；然而，腹腔内有液体的病例中，有3 - 13%未被超声显示。如果钝性创伤后仅显示少量腹腔内液体，采取观望态度是合理的。在重症监护情况下，如有必要，超声可重复检查多次。在本研究中，超声在这些情况下有25%显示病情恶化，且有21%预计必须进行手术。
