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胸部创伤的放射学表现。

Radiologic findings of thoracic trauma.

作者信息

Akgul Ozmen Cihan, Onat Serdar, Aycicek Delal

机构信息

Department of Radiology.

Department of Chest Surgery, Dicle University School of Medicine, Diyarbakir.

出版信息

Ther Clin Risk Manag. 2017 Aug 26;13:1085-1089. doi: 10.2147/TCRM.S143845. eCollection 2017.

Abstract

INTRODUCTION

Chest trauma may be blunt or penetrating and the chest is the third most common trauma region. It is a significant cause of mortality. Multidetector computed tomography (MDCT) has been an increasingly used method to evaluate chest trauma because of its high success in detecting tissue and organ injuries. Herein, we aimed to present MDCT findings in patients with blunt and penetrating chest trauma admitted to our department.

METHODS

A total of 240 patients admitted to the emergency department of our hospital between April 2012 and July 2013 with a diagnosis of chest trauma who underwent MDCT evaluations were included. Most of the patients were male (83.3%) and victims of a blunt chest trauma. The images were analyzed with respect to the presence of fractures of bony structures, hemothorax, pneumothorax, mediastinal organ injury, and pulmonary and vascular injuries.

RESULTS

MDCT images of the 240 patients yielded a prevalence of 41.7% rib fractures, 11.2% scapular fractures, and 7.5% clavicle fractures. The prevalence of thoracic vertebral fracture was 13.8% and that of sternal fracture was 3.8%. The prevalence of hemothorax, pneumothorax, pneumomediastinum, and subcutaneous emphysema was 34.6%, 62.1%, 9.6%, and 35.4%, respectively. The prevalence of rib, clavicle, and thoracic vertebral fractures and pulmonary contusion was higher in the blunt trauma group, whereas the prevalence of hemothorax, subcutaneous emphysema, diaphragmatic injury, and other vascular lacerations was significantly higher in the penetrating trauma group than in the blunt trauma group (<0.05).

CONCLUSION

MDCT images may yield a high prevalence of fracture of bony structures, soft tissue lacerations, and vascular lesions, which should be well understood by radiologists dealing with trauma.

摘要

引言

胸部创伤可分为钝性伤和穿透伤,胸部是第三大常见创伤部位。它是导致死亡的重要原因。多排螺旋计算机断层扫描(MDCT)因其在检测组织和器官损伤方面的高成功率,已成为评估胸部创伤越来越常用的方法。在此,我们旨在展示我院收治的钝性和穿透性胸部创伤患者的MDCT表现。

方法

纳入2012年4月至2013年7月期间我院急诊科收治的240例诊断为胸部创伤并接受MDCT评估的患者。大多数患者为男性(83.3%),且为钝性胸部创伤的受害者。对图像进行分析,观察骨性结构骨折、血胸、气胸、纵隔器官损伤以及肺和血管损伤的情况。

结果

240例患者的MDCT图像显示肋骨骨折患病率为41.7%,肩胛骨骨折患病率为11.2%,锁骨骨折患病率为7.5%。胸椎骨折患病率为13.8%,胸骨骨折患病率为3.8%。血胸、气胸、纵隔气肿和皮下气肿的患病率分别为34.6%、62.1%、9.6%和35.4%。钝性创伤组肋骨、锁骨和胸椎骨折以及肺挫伤的患病率较高,而穿透性创伤组血胸、皮下气肿、膈肌损伤和其他血管撕裂伤的患病率显著高于钝性创伤组(<0.05)。

结论

MDCT图像可能显示较高的骨性结构骨折、软组织撕裂伤和血管病变患病率,处理创伤的放射科医生应充分了解这些情况。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f6f3/5584910/e80fa444191e/tcrm-13-1085Fig1.jpg

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