Erasmie U, Mortensson W, Persson U, Lännergren K
Department of Pediatric Radiology, St. Göran's Children's Hospital, Stockholm, Sweden.
Acta Radiol. 1988 Jan-Feb;29(1):121-5.
Ninety-eight children with recent blunt abdominal trauma which initially evoked clinical suspicion of splenic injury were examined with colloid scintigraphy of the spleen and the liver using multiple imaging views and with abdominal survey. Nineteen children were, in addition, examined with tomographic scintigraphy. The clinical findings and the course of the disorder were reanalyzed. Scintigraphy indicated splenic injury in 56 children and hepatic injury in another 5 children. The left lateral and the left oblique were the optimum imaging views for detecting splenic ruptures. Tomographic scintigraphy did not improve the diagnostic yield. Abdominal survey failed to indicate almost every second case of splenic rupture and provided no additional information of significance. The clinical review agreed with the scintigraphic diagnosis of splenic lesions but, in addition, it suggested possible splenic lesions in another 10 children with normal scintigraphy. This discrepancy cannot be explained as surgery was not employed; the occurrence of splenic lesions too small to become detectable at scintigraphy or to provoke clinically evident symptoms may be supposed.
对98名近期发生钝性腹部创伤且最初临床怀疑有脾损伤的儿童，采用多视角成像对脾脏和肝脏进行胶体闪烁扫描检查，并进行腹部检查。另外，对19名儿童进行了断层闪烁扫描检查。重新分析临床检查结果和疾病发展过程。闪烁扫描显示56名儿童有脾损伤，另有5名儿童有肝损伤。左侧卧位和左斜位是检测脾破裂的最佳成像视角。断层闪烁扫描并未提高诊断率。腹部检查几乎漏诊了一半的脾破裂病例，且未提供其他有意义的额外信息。临床复查与闪烁扫描对脾损伤的诊断结果一致，但此外，复查还提示另有10名闪烁扫描结果正常的儿童可能存在脾损伤。由于未进行手术，这种差异无法解释；可能存在一些脾损伤过小，在闪烁扫描中无法检测到或未引发明显临床症状的情况。
