Vade A, Demos T C, Salvino C, Korach J L
Department of Radiology, Loyola University Medical Center, Maywood, IL 60153.
Clin Imaging. 1994 Jul-Sep;18(3):189-94. doi: 10.1016/0899-7071(94)90080-9.
This is a retrospective study of the computed tomography (CT) examinations and medical records of 243 consecutive pediatric patients sent for CT studies after blunt abdominal trauma. The purpose of the study was to determine the frequency and significance of periportal tracking identified by CT, and correlate this finding with liver enzyme levels and liver injury. Periportal tracking (PPT) was divided into four grades (0-3) depending upon the distribution of decreased attenuation adjacent to the portal vessels. Circumferential PPT extending to the periphery of the liver (grade 3) was found in 20/243 children. They had a higher incidence of liver parenchymal injury seen on CT 20% versus 0.5% in combined PPT grades 0-2. Sixteen children with grade 3 PPT and no liver injury had significantly elevated liver enzymes as compared to children with combined 0-2 grade PPT. Eleven of the 20 children with grade 3 PPT had no other CT evidence of intraabdominal injury and none of these patients developed intraabdominal hemorrhage. Thus, grade 3 periportal tracking as an isolated abnormality did not indicate a clinically significant liver injury in any patient.
这是一项回顾性研究，纳入了243例因钝性腹部创伤接受计算机断层扫描（CT）检查的连续儿科患者的CT检查结果和病历。本研究的目的是确定CT识别出的门静脉周围追踪的频率和意义，并将这一发现与肝酶水平和肝损伤相关联。根据门静脉血管旁衰减降低的分布情况，门静脉周围追踪（PPT）分为四个等级（0 - 3级）。在243例儿童中，有20例发现延伸至肝周边的环形PPT（3级）。与PPT 0 - 2级合并组相比，他们在CT上肝实质损伤的发生率更高（20% 对比0.5%）。与PPT 0 - 2级合并组的儿童相比，16例3级PPT且无肝损伤的儿童肝酶显著升高。20例3级PPT儿童中有11例没有其他腹部内损伤的CT证据，且这些患者均未发生腹腔内出血。因此，单独出现的3级门静脉周围追踪在任何患者中均未提示具有临床意义的肝损伤。
