Sivit C J, Taylor G A, Eichelberger M R, Bulas D I, Gotschall C S, Kushner D C
Department of Diagnostic Imaging and Radiology, Children's National Medical Center, Washington, DC.
Pediatr Radiol. 1993;23(5):388-90. doi: 10.1007/BF02011968.
The CT scans of 400 consecutive children evaluated with CT following blunt abdominal trauma were evaluated to determine the frequency of periportal low-attenuation zones, assess patterns of associated intraabdominal injury, and examine clinical outcome. Periportal low-attenuation zones were noted in 60 children (15%). The presence of these zones was associated with a significantly higher incidence of intraabdominal injury (60% versus 11%, p = 0.0001). Injuries most frequently associated with zones of periportal low-attenuation included hepatic (n = 23, 38%), and adrenal (n = 14, 23%). Children who had periportal low-attenuation zones tended to be more physiologically unstable as evidenced by a lower Trauma Score (diffuse, 11.9; focal, 13.4) than children without the zones (15.1, p = 0.0001). The presence of these zones was also associated with a significantly higher mortality rate (13% versus 1%, p = 0.0001). Ten children who had periportal low-attenuation zones and no hepatic injury on CT had a normal appearing liver on gross inspection at surgery or autopsy. In conclusion, periportal low-attenuation zones are common in children who have hepatic injury. These zones may be seen in conjunction with non-hepatic visceral injury or in the absence of intraabdominal injury. The presence of zones of periportal low-attenuation is associated with a higher index of physiologic instability, and higher mortality.
对400例腹部钝性创伤后接受CT检查的连续儿童的CT扫描结果进行评估，以确定肝门周围低密度区的发生率，评估相关腹腔内损伤的模式，并检查临床结局。60例儿童（15%）发现有肝门周围低密度区。这些区域的存在与腹腔内损伤的发生率显著升高相关（60%对11%，p = 0.0001）。与肝门周围低密度区最常相关的损伤包括肝脏损伤（n = 23，38%）和肾上腺损伤（n = 14，23%）。有肝门周围低密度区的儿童生理上往往更不稳定，这表现为创伤评分低于无此区域的儿童（弥漫性，11.9；局灶性，13.4）（15.1，p = 0.0001）。这些区域的存在还与显著更高的死亡率相关（13%对1%，p = 0.0001）。10例CT显示有肝门周围低密度区但无肝脏损伤的儿童，在手术或尸检时大体检查肝脏外观正常。总之，肝门周围低密度区在有肝脏损伤的儿童中很常见。这些区域可能与非肝脏内脏损伤同时出现，也可能在无腹腔内损伤时出现。肝门周围低密度区的存在与更高的生理不稳定指数和更高的死亡率相关。
