Yang Xu-Yang, Wei Ming-Tian, Jin Cheng-Wu, Wang Meng, Wang Zi-Qiang
From the Department of Gastrointestinal Surgery, West China Hospital, Sichuan University (X-YY, M-TW, MW, Z-QW) and Department of Gastrointestinal Surgery, The Fifth People's Hospital of Chengdu (C-WJ), Chengdu, Sichuan, China.
Medicine (Baltimore). 2016 Mar;95(9):e2884. doi: 10.1097/MD.0000000000002884.
To identify and describe the major features of unenhanced computed tomography (CT) images of blunt hollow viscera and/or mesenteric injury (BHVI/MI) and to determine the value of unenhanced CT in the diagnosis of BHVI/MI. This retrospective study included 151 patients who underwent unenhanced CT before laparotomy for blunt abdominal trauma between January 2011 and December 2013. According to surgical observations, patients were classified as having BHVI/MI (n = 73) or not (n = 78). Sensitivity, specificity, P values, and likelihood ratios were calculated by comparing CT findings between the 2 groups. Six significant CT findings (P < 0.05) for BHVI/MI were identified and their sensitivity and specificity values determined, as follows: bowel wall thickening (39.7%, 96.2%), mesentery thickening (46.6%, 88.5%), mesenteric fat infiltration (12.3%, 98.7%), peritoneal fat infiltration (31.5%, 87.1%), parietal peritoneum thickening (30.1%, 85.9%), and intra- or retro-peritoneal air (34.2%, 96.2%). Unenhanced CT scan was useful as an initial assessment tool for BHVI/MI after blunt abdominal trauma. Six key features on CT were correlated with BHVI/MI.
识别并描述钝性中空脏器和/或肠系膜损伤（BHVI/MI）的平扫计算机断层扫描（CT）图像的主要特征，并确定平扫CT在BHVI/MI诊断中的价值。这项回顾性研究纳入了2011年1月至2013年12月期间因钝性腹部创伤在剖腹手术前行平扫CT检查的151例患者。根据手术观察结果，将患者分为有BHVI/MI（n = 73）和无BHVI/MI（n = 78）两组。通过比较两组的CT表现计算敏感性、特异性、P值和似然比。确定了6项BHVI/MI的显著CT表现（P < 0.05），并确定了其敏感性和特异性值，具体如下：肠壁增厚（39.7%，96.2%）、肠系膜增厚（46.6%，88.5%）、肠系膜脂肪浸润（12.3%，98.7%）、腹膜脂肪浸润（31.5%，87.1%）、壁腹膜增厚（30.1%，85.9%）以及腹内或腹膜后积气（34.2%，96.2%）。平扫CT扫描作为钝性腹部创伤后BHVI/MI的初始评估工具是有用的。CT上的6项关键特征与BHVI/MI相关。
