Cholankeril J V, Zamora B O, Ketyer S
J Comput Tomogr. 1984 Jul;8(3):261-7. doi: 10.1016/0149-936x(84)90074-2.
Computed tomography scanning has become one of the prime modalities in the diagnosis of trauma to the spleen (1-6). We present three cases of potential pitfall in computed tomography scan diagnosis. In the first case, computed tomography scan showed a high-attenuation perisplenic density in the superio-lateral region of the spleen compatible with a perisplenic hematoma. Exploratory surgery showed a left lobe of the liver draping around the spleen. The second case showed similar computed tomography findings as in the first case, but the perisplenic density showed enhancement after contrast infusion. Also, on careful evaluation, the perisplenic density was traced as part of the left lobe of the liver. The third case, an alcoholic without any history of trauma, showed a perisplenic density of lower attenuation. On careful screening, this was traced as part of the left lobe of the liver. The lower attenuation value of the liver was due to fatty infiltration. The importance of performing computed tomography with and without contrast infusion in these cases is discussed.
计算机断层扫描已成为脾脏创伤诊断的主要手段之一(1 - 6)。我们介绍三例计算机断层扫描诊断中可能出现的陷阱病例。第一例中，计算机断层扫描显示脾脏上外侧区域脾周密度增高，符合脾周血肿表现。探查手术发现肝脏左叶覆盖在脾脏周围。第二例计算机断层扫描结果与第一例相似，但脾周密度在注入造影剂后有强化。仔细评估后发现，脾周密度是肝脏左叶的一部分。第三例是一名无任何创伤史的酗酒者，显示脾周密度较低。经仔细筛查，发现这是肝脏左叶的一部分。肝脏密度较低是由于脂肪浸润。文中讨论了在这些病例中进行有无造影剂注入的计算机断层扫描的重要性。
