Michel L A, Lacrosse M, Decannière L, Lorge F, Rosière A, Vandenbossche P, Trigaux J P
Service of Surgery, University of Louvain School of Medicine, Mont-Godinne University Hospital, Yvoir, Belgium.
Int Surg. 1996 Oct-Dec;81(4):377-81.
Spiral CT has proved to be a valuable tool by providing various kinds of three-dimensional (3D) images of the studied structures. Such 3D images, which offer a more realistic depiction of the lesions, could be of interest for surgeons who are attempting to treat conservatively blunt abdominal traumas and lead to less inappropriate triage between conservative and operative management particularly for renal trauma. A good working relationship between surgeons and radiologists allowed us to perform an early follow-up 3D spiral CT on a commercially available spiral CT scanner. In the first adult patient, the 3D CT demonstrated minor spleen injury associated with severe lacerations of the left kidney with complete separation of the kidney lower pole. A delayed partial lower nephrectomy was performed. For the second 12-year-old patient presenting with severe spleen trauma and macroscopic hematuria, the 3D CT accurately documented the spleen and renal lesions that were safely amenable to nonoperative treatment. For hemodynamically stable patients, 3D CT is a potentially helpful addition to conventional axial CT for quantifying blunt renal traumas and for making the strategic choice between nonoperative, emergency or delayed surgical treatment.
螺旋CT已被证明是一种有价值的工具，它可以提供所研究结构的各种三维（3D）图像。这种3D图像能够更真实地描绘病变情况，对于试图保守治疗钝性腹部创伤的外科医生来说可能很有意义，并且在保守治疗和手术治疗之间，尤其是肾创伤时，可减少不适当的分诊。外科医生和放射科医生之间良好的工作关系使我们能够在商用螺旋CT扫描仪上进行早期随访3D螺旋CT检查。在第一例成年患者中，3D CT显示脾脏轻度损伤，伴有左肾严重裂伤，肾下极完全分离。实施了延迟性部分肾下极切除术。对于第二例12岁严重脾脏创伤并伴有肉眼血尿的患者，3D CT准确记录了脾脏和肾脏病变，这些病变适合非手术治疗。对于血流动力学稳定的患者，3D CT是传统轴向CT的潜在有用补充，可用于量化钝性肾创伤，并在非手术、急诊或延迟手术治疗之间做出策略性选择。
