Boscak Alexis, Shanmuganathan Kathirkamanthan
Trauma/Emergency Section, Department of Radiology, University of Maryland Medical Center, Baltimore, MD 21201, USA.
Radiol Clin North Am. 2012 Jan;50(1):105-22. doi: 10.1016/j.rcl.2011.08.008.
Evaluation for splenic injury is an important component of patient assessment after blunt abdominal trauma. Key imaging modalities include ultrasound, particularly for rapid identification of hemoperitoneum, and computed tomography (CT), which permits a more detailed and accurate determination of splenic integrity. Specific findings at contrast-enhanced multidetector CT (MDCT) should prompt the consideration of catheter angiography with arterial embolization as an adjunct to nonsurgical management. This article reviews the roles of imaging in the management of splenic trauma, illustrates the MDCT appearance of various splenic injuries, and discusses imaging-based indications for operative and angiographic intervention.
脾脏损伤评估是钝性腹部创伤后患者评估的重要组成部分。关键的影像学检查方法包括超声,特别是用于快速识别腹腔积血,以及计算机断层扫描(CT),它能更详细、准确地确定脾脏的完整性。对比增强多层螺旋CT(MDCT)的特定表现应促使考虑采用导管血管造影及动脉栓塞作为非手术治疗的辅助手段。本文综述了影像学在脾脏创伤管理中的作用,阐述了各种脾脏损伤的MDCT表现,并讨论了基于影像学的手术和血管造影干预指征。