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胸壁创伤——X线片上的误诊病变以及超声、多排螺旋计算机断层扫描和磁共振成像的应用价值

Thoracic wall trauma-misdiagnosed lesions on radiographs and usefulness of ultrasound, multidetector computed tomography and magnetic resonance imaging.

作者信息

Tomas Xavier, Facenda Catherine, Vaz Nuno, Castañeda Edgar Augusto, Del Amo Montserrat, Garcia-Diez Ana Isabel, Pomes Jaime

机构信息

Department of Radiology, The Clinical Diagnostic Imaging Centre (CDIC), Hospital Clinic, Universitat de Barcelona (UB), Villarroel 170, 08036 Barcelona, Spain.

Department of Radiology, Hospital Universitari Arnau de Vilanova, Av. Alcalde Rovira Roure, 80, Lleida 25198, Spain.

出版信息

Quant Imaging Med Surg. 2017 Aug;7(4):384-397. doi: 10.21037/qims.2017.08.02.

Abstract

Blunt injuries to the chest wall are an important chapter on emergency room (ER) departments, being the third most common injuries in trauma patients which ominous complications could appear. This article describes different types of traumatic events affecting the chest wall, which maybe misdiagnosed with conventional X-ray. Special emphasis has been done in computed tomography (CT) and multidetector CT (MDCT) imaging. This technique is considered the "gold-standard" for those traumatic patients, due to its fast acquisition covering the whole area of interest in axial plane, reconstructing multiplanar (2D, 3D) volume-rendered images with a superb quality and angiographic CT capabilities for evaluating vascular damage. Complementary techniques such as ultrasonography (US) and magnetic resonance imaging (MRI) may improve the diagnostic accuracy due to its great capacity in visualising soft-tissue trauma (muscle-tendinous tears) and subtle fractures. All these imaging methods have an important role in quantifying the severity of chest wall trauma. The findings of this study have been exposed with cases of our archives in a didactic way.

摘要

胸壁钝性损伤是急诊室的一个重要内容,是创伤患者中第三常见的损伤,可能会出现严重并发症。本文描述了影响胸壁的不同类型创伤事件,这些事件可能会被传统X线误诊。特别强调了计算机断层扫描(CT)和多排探测器CT(MDCT)成像。由于该技术能够快速采集轴向平面上整个感兴趣区域的图像,以高质量重建多平面(二维、三维)容积再现图像,并具有血管造影CT功能来评估血管损伤,因此被认为是这些创伤患者的“金标准”。超声(US)和磁共振成像(MRI)等辅助技术由于在可视化软组织创伤(肌腱撕裂)和细微骨折方面具有强大能力,可能会提高诊断准确性。所有这些成像方法在量化胸壁创伤的严重程度方面都起着重要作用。本研究的结果已通过我们档案中的病例以教学方式呈现。

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