Oikonomou Anastasia, Prassopoulos Panos
Department of Radiology, University Hospital of Alexandroupolis, Democritus University of Thrace, Dragana, 68100 Alexandroupolis, Thrace Greece.
Insights Imaging. 2011 Jun;2(3):281-295. doi: 10.1007/s13244-011-0072-9. Epub 2011 Feb 11.
Thoracic injury overall is the third most common cause of trauma following injury to the head and extremities. Thoracic trauma has a high morbidity and mortality, accounting for approximately 25% of trauma-related deaths, second only to head trauma. More than 70% of cases of blunt thoracic trauma are due to motor vehicle collisions, with the remainder caused by falls or blows from blunt objects. METHODS: The mechanisms of injury, spectrum of abnormalities and radiological findings encountered in blunt thoracic trauma are categorised into injuries of the pleural space (pneumothorax, hemothorax), the lungs (pulmonary contusion, laceration and herniation), the airways (tracheobronchial lacerations, Macklin effect), the oesophagus, the heart, the aorta, the diaphragm and the chest wall (rib, scapular, sternal fractures and sternoclavicular dislocations). The possible coexistence of multiple types of injury in a single patient is stressed, and therefore systematic exclusion after thorough investigation of all types of injury is warranted. RESULTS: The superiority of CT over chest radiography in diagnosing chest trauma is well documented. Moreover, with the advent of MDCT the imaging time for trauma patients has been significantly reduced to several seconds, allowing more time for appropriate post-diagnosis care. CONCLUSION: High-quality multiplanar and volumetric reformatted CT images greatly improve the detection of injuries and enhance the understanding of mechanisms of trauma-related abnormalities.
胸部损伤总体上是继头部和四肢损伤之后第三常见的创伤原因。胸部创伤具有较高的发病率和死亡率,约占创伤相关死亡的25%,仅次于头部创伤。超过70%的钝性胸部创伤病例是由机动车碰撞所致,其余由跌倒或钝器打击引起。方法:钝性胸部创伤中遇到的损伤机制、异常谱和影像学表现分为胸膜腔损伤(气胸、血胸)、肺损伤(肺挫伤、撕裂伤和疝)、气道损伤(气管支气管撕裂伤、麦克林效应)、食管损伤、心脏损伤、主动脉损伤、膈肌损伤和胸壁损伤(肋骨、肩胛骨、胸骨骨折和胸锁关节脱位)。强调了单一患者可能同时存在多种类型损伤的情况,因此在对所有类型损伤进行全面检查后进行系统排除是必要的。结果:CT在诊断胸部创伤方面优于胸部X线摄影,这一点已有充分记录。此外,随着多层螺旋CT的出现,创伤患者的成像时间已显著缩短至几秒,为诊断后的适当护理留出了更多时间。结论:高质量的多平面和容积重组CT图像极大地提高了损伤的检测率,并增强了对创伤相关异常机制的理解。